Nav: Home

Breast cancer and lymphoma treatments save lives, but may make heart failure more likely for some

February 28, 2018

WASHINGTON (Feb. 28, 2018) - Patients with a history of breast cancer or lymphoma were more than three times as likely to develop heart failure -- a condition in which the heart can't pump enough blood to meet the body's needs--compared with a similar group of patients who did not have cancer, according to data being presented at the American College of Cardiology's 67th Annual Scientific Session.

A team of researchers at Mayo Clinic found the elevated risk of heart failure occurred as early as one year after cancer diagnosis and persisted 20 years after patients completed cancer therapy. Among those with cancer, having diabetes or receiving high doses of doxorubicin--a type of chemotherapy--were found to be especially risky for future heart health.

The study, part of Mayo Clinic's Rochester Epidemiological Project, is one of the the first to the researchers' knowledge to directly compare the rate of heart failure in cancer versus non-cancer patients who were well-matched for age, gender and heart disease risk factors, such as diabetes and high blood pressure. Researchers tracked heart failure cases in 1,550 people without cancer and in 900 breast cancer and lymphoma patients in Olmsted County, Minnesota, from 1985 to 2010. About 7 out of every 100 cancer patients developed heart failure during the median follow-up of 8.5 years. People with breast cancer or lymphoma were three times as likely to develop heart failure within five years of their cancer diagnosis, and 20 years following cancer treatment were still nearly twice as likely to have been diagnosed with heart failure compared to similar patients who didn't undergo cancer therapy.

"The risk of heart failure doesn't go away after a couple of years. It's a long-term issue that patients need to discuss with their doctors and use as motivation to stay heart healthy," said Carolyn Larsen, MD, assistant professor of medicine at Mayo Clinic and the study's lead author. "Cancer patients need to have good primary care and cardiology follow-up to make sure all of their risk factors for heart disease are optimally controlled. They should also be assessed for signs and symptoms of heart failure every year so that they can be diagnosed and started on appropriate medical treatment early on."

Among those who had cancer, some had a higher likelihood of facing a heart failure diagnosis than others. For example, when controlling for multiple heart disease risk factors (e.g., age, diabetes, high blood pressure), receiving higher doses of doxorubicin (? 300 mg/m2) and diabetes emerged as the greatest risk factors in the studied population of cancer patients, more than doubling a patient's risk of heart failure. Larsen said additional research is needed to determine why diabetes carries a greater risk than other traditional risk factors, such as high blood pressure, in this group. Anthracycline drugs, such as doxorubicin, are known to cause heart failure because they cause changes in the DNA structure of the heart muscle cells, leading to irreversible cardiac damage. The damage is related to the cumulative dose of these drugs patients receive over the course of their treatment. In order to reduce the risk of heart damage, clinicians today use the lowest effective dose of anthracyclines or avoid anthracyclines all together when other equally effective treatment options are available.

Still, Larsen said the findings raise important questions about what the appropriate surveillance should be for heart problems post-cancer treatment and suggested that more frequent cardiac imaging may be warranted in some patients to detect signs of heart failure earlier.

"It's an area that needs to be better defined. An echocardiogram is usually done six to 12 months after cancer treatment with an anthracycline, but how often should it be done after that?" she said, explaining there are many differing expert recommendations on the subject with opinions ranging from annually to only if signs or symptoms of heart failure develop. "We need to be more vigilant in making sure we try to prevent or control heart issues post-cancer care, especially in light of the growing appreciation of the connection between some cancer treatments and heart disease."

Larsen emphasized that heart failure is by no means inevitable in patients receiving chemotherapy treatment. One in 10 cancer patients were diagnosed with heart failure in the 20 years following their cancer diagnosis. Additionally, even with heightened risk, a heart healthy lifestyle--maintaining a normal body weight, regular exercise and controlling other risk factors such as high blood pressure, diabetes and high cholesterol--can help lower the risk of heart disease and heart failure.

"If patients know they have received a drug treatment that might increase their risk of heart failure, it's even more important to take care of the aspects of their life that they can control to reduce their risk as much as possible and to work with their medical care team to detect issues as early as possible," Larsen said.

More than 6 million Americans live with heart failure, a number that is projected to jump to 8 million by 2030. Heart failure signs and symptoms include: shortness of breath, swelling especially in the legs or abdomen, fatigue, feelings of weakness, rapid or irregular heartbeat, fast weight gain, and pressure or heaviness in the chest when lying flat. This was a retrospective study and some patients moved away from Olmsted County during the study period, which may have led to underestimated rates of heart failure in cancer patients and non-cancer patients alike.

Larsen will present the study, "Short and Long-Term Risk of Congestive Heart Failure in Breast Cancer and Lymphoma Patients Compared to Controls: an Epidemiologic Study," on Saturday, March 10 at 10:00 a.m. ET in Poster Hall A/B.
-end-
The ACC's Annual Scientific Session, which will take place March 10-12 in Orlando, brings together cardiologists and cardiovascular specialists from around the world to share the newest discoveries in treatment and prevention. Follow @ACCinTouch, @ACCMediaCenter and #ACC18 for the latest news from the meeting.

The American College of Cardiology is a 52,000-member medical society that is the professional home for the entire cardiovascular care team. The mission of the College is to transform cardiovascular care and to improve heart health. The ACC leads in the formation of health policy, standards and guidelines. The College operates national registries to measure and improve care, offers cardiovascular accreditation to hospitals and institutions, provides professional medical education, disseminates cardiovascular research and bestows credentials upon cardiovascular specialists who meet stringent qualifications.

American College of Cardiology

Related Breast Cancer Articles:

Breast cancer: AI predicts which pre-malignant breast lesions will progress to advanced cancer
New research at Case Western Reserve University in Cleveland, Ohio, could help better determine which patients diagnosed with the pre-malignant breast cancer commonly as stage 0 are likely to progress to invasive breast cancer and therefore might benefit from additional therapy over and above surgery alone.
Partial breast irradiation effective treatment option for low-risk breast cancer
Partial breast irradiation produces similar long-term survival rates and risk for recurrence compared with whole breast irradiation for many women with low-risk, early stage breast cancer, according to new clinical data from a national clinical trial involving researchers from The Ohio State University Comprehensive Cancer Center - Arthur G.
Breast screening linked to 60 per cent lower risk of breast cancer death in first 10 years
Women who take part in breast screening have a significantly greater benefit from treatments than those who are not screened, according to a study of more than 50,000 women.
More clues revealed in link between normal breast changes and invasive breast cancer
A research team, led by investigators from Georgetown Lombardi Comprehensive Cancer Center, details how a natural and dramatic process -- changes in mammary glands to accommodate breastfeeding -- uses a molecular process believed to contribute to survival of pre-malignant breast cells.
Breast tissue tumor suppressor PTEN: A potential Achilles heel for breast cancer cells
A highly collaborative team of researchers at the Medical University of South Carolina and Ohio State University report in Nature Communications that they have identified a novel pathway for connective tissue PTEN in breast cancer cell response to radiotherapy.
Computers equal radiologists in assessing breast density and associated breast cancer risk
Automated breast-density evaluation was just as accurate in predicting women's risk of breast cancer, found and not found by mammography, as subjective evaluation done by radiologists, in a study led by researchers at UC San Francisco and Mayo Clinic.
Blood test can effectively rule out breast cancer, regardless of breast density
A new study published in PLOS ONE demonstrates that Videssa® Breast, a multi-protein biomarker blood test for breast cancer, is unaffected by breast density and can reliably rule out breast cancer in women with both dense and non-dense breast tissue.
Study shows influence of surgeons on likelihood of removal of healthy breast after breast cancer dia
Attending surgeons can have a strong influence on whether a patient undergoes contralateral prophylactic mastectomy after a diagnosis of breast cancer, according to a study published by JAMA Surgery.
Young breast cancer patients undergoing breast conserving surgery see improved prognosis
A new analysis indicates that breast cancer prognoses have improved over time in young women treated with breast conserving surgery.
Does MRI plus mammography improve detection of new breast cancer after breast conservation therapy?
A new article published by JAMA Oncology compares outcomes for combined mammography and MRI or ultrasonography screenings for new breast cancers in women who have previously undergone breast conservation surgery and radiotherapy for breast cancer initially diagnosed at 50 or younger.
More Breast Cancer News and Breast Cancer Current Events

Trending Science News

Current Coronavirus (COVID-19) News

Top Science Podcasts

We have hand picked the top science podcasts of 2020.
Now Playing: TED Radio Hour

Teaching For Better Humans 2.0
More than test scores or good grades–what do kids need for the future? This hour, TED speakers explore how to help children grow into better humans, both during and after this time of crisis. Guests include educators Richard Culatta and Liz Kleinrock, psychologist Thomas Curran, and writer Jacqueline Woodson.
Now Playing: Science for the People

#556 The Power of Friendship
It's 2020 and times are tough. Maybe some of us are learning about social distancing the hard way. Maybe we just are all a little anxious. No matter what, we could probably use a friend. But what is a friend, exactly? And why do we need them so much? This week host Bethany Brookshire speaks with Lydia Denworth, author of the new book "Friendship: The Evolution, Biology, and Extraordinary Power of Life's Fundamental Bond". This episode is hosted by Bethany Brookshire, science writer from Science News.
Now Playing: Radiolab

Space
One of the most consistent questions we get at the show is from parents who want to know which episodes are kid-friendly and which aren't. So today, we're releasing a separate feed, Radiolab for Kids. To kick it off, we're rerunning an all-time favorite episode: Space. In the 60's, space exploration was an American obsession. This hour, we chart the path from romance to increasing cynicism. We begin with Ann Druyan, widow of Carl Sagan, with a story about the Voyager expedition, true love, and a golden record that travels through space. And astrophysicist Neil de Grasse Tyson explains the Coepernican Principle, and just how insignificant we are. Support Radiolab today at Radiolab.org/donate.