Abstract 754
Background
Pre-existing CVD risk factors in women with breast cancer increases their risk of developing adjuvant therapy induced cardiotoxicity. We measured the prevalence of major CVD risk factors in women newly diagnosed with breast cancer in a multiethnic setting.
Methods
From 2015 to 2017, 2159 women with newly diagnosed invasive breast cancer were consecutively recruited from four tertiary hospitals in Malaysia. Demographic, medical and drug history were collected through interviews and verified with medical records. Pre-treatment height, weight, blood pressure, serum glucose, and cholesterol levels were measured. Risk of cardiotoxicity was estimated using the Cardiotoxicity Risk Score proposed by Herrmann, et al.
Results
Median age at diagnosis was 54 years. Median tumor size at presentation was 2.7 cm and 54% had node-negative disease. A majority (70%) of patients had estrogen receptor positive tumors. Prevalence of hypertension was 43%, while hypercholesterolemia was found in 48%. Seventeen percent of patients had diabetes mellitus and 19% were obese. Only 2% were current smokers. Four percent of patients had pre-existing coronary heart disease, arrhythmias or valvular disease. Overall, 40% of patients presented with two or more major CVD risk factors (clustering). The clustering of CVD risk factors was substantial across all age groups; age < 40 years: 16%, 40-49 years: 24%, 50-64 years: 46%, > =65 years: 62%. The Malay and Indian patients were twice more likely to have CVD risk clustering than the Chinese. Of 1880 patients with non-metastatic breast cancer, 45% were planned for anthracycline-based chemotherapy, and 54% for adjuvant radiotherapy. Taking the adjuvant treatment plan into account, it appeared that approximately one in two women with breast cancer in our settings were at high risk of developing cardiotoxicity.
Conclusions
Our findings highlight the need to accelerate the establishment of coordinated partnerships between the oncology and cardiology specialties to improve cardiac outcomes following breast cancer. In the era of precision medicine, these findings also lend support to the notion that the next generation adjuvant therapy decision-making tools in breast cancer should incorporate data on major CVD risk factors.
Clinical trial identification
Legal entity responsible for the study
Nirmala Bhoo-Pathy.
Funding
Has not received any funding.
Editorial Acknowledgement
Disclosure
All authors have declared no conflicts of interest.