Patients with advanced breast cancer at diagnosis had a 10% higher likelihood of having preexisting cardiovascular disease, particularly in hormone receptor-positive cases, according to a recent study.
Researchers investigated the association between cardiovascular disease (CVD) and advanced breast cancer stage at diagnosis in a case-control study. The study, published in JAMA Network Open, utilized data from the Surveillance, Epidemiology, and End Results–Medicare linked databases to examine whether patients with advanced breast cancer at diagnosis were more likely to have prevalent CVD compared to those with early-stage disease. The cohort comprised 19,292 female patients aged 66 years or older diagnosed with invasive breast cancer between 2010 and 2019.
The researchers applied a propensity score–matched design to control for factors associated with delayed cancer diagnosis, including age, race, socioeconomic status, and healthcare utilization. CVD status was determined from the 13 to 24 months preceding breast cancer diagnosis to avoid confounding from concurrent diagnoses. Cases of advanced breast cancer (T3-4, N+, or M+) were matched 1:1 with controls who had early-stage breast cancer (T1-2, N0, M0).
The results showed that 49.1% (n = 9,478) of the patients had prevalent CVD. Those with advanced breast cancer had a 10% higher likelihood of having CVD compared to controls (odds ratio [OR], 1.10; 95% confidence interval [CI], 1.03–1.17; P = .007). Stratified analyses revealed a significant association in hormone receptor-positive cases (OR, 1.11; 95% CI, 1.03–1.19; P = .006) but not in hormone receptor-negative cases (OR, 1.02; 95% CI, 0.86–1.21; P = .83). When evaluated by disease subtypes, patients with locally advanced breast cancer exhibited an elevated risk of CVD (OR, 1.09; 95% CI, 1.02–1.17; P = .02), while the association for metastatic disease was not statistically significant (OR, 1.20; 95% CI, 0.94–1.54; P = .15).
The findings suggest that CVD may be associated with advanced breast cancer, particularly in hormone receptor-positive and ERBB2-negative subtypes. The researchers emphasized that while the observational nature of the study limits causal inferences, the results are consistent with prior evidence indicating a potential biological link between CVD and tumor progression. Further studies are necessary to determine whether personalized cancer screening strategies for patients with CVD could enhance early detection and improve outcomes. Limitations of the study include reliance on administrative data and limited racial diversity in the cohort.
Full disclosures can be found in the published study.
