Women at Risk for Heart Problems After Breast Cancer Treatment

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Breast cancer survivors understandably may be more concerned about the risk of breast cancer coming back (recurrence) than other health issues. Still, a study found that the risk of a serious heart problem, such as a stroke or heart attack, often was the same or greater than the risk of breast cancer recurrence. The results were presented at the 2009 ASCO Breast Cancer Symposium.

The researchers looked at the health histories of 242 postmenopausal women treated for hormone-receptor-positive early-stage stage breast cancer and calculated the risk of breast cancer recurrence and a serious heart problem over 10 years using two tools.

Adjuvant! Online is an Internet tool that allows doctors and patients to calculate the risk of early-stage breast cancer recurrence over time, based on specific health and personal factors. Determining recurrence risk can help you and your doctor decide if treatments to lower recurrence risk, such as chemotherapy, make sense for your unique situation.

The Framingham Heart Study was a large, long-term study. Doctors use the results of the Framingham Study to calculate the risk of heart attack and stroke for a person, based on specific health and personal factors.

The results:

  • 3% of the women were at HIGH risk of recurrence
  • 12% of the women were at HIGH risk of a serious heart problem

High risk meant that the women's risk of recurrence or having a heart problem in 10 years was higher than 25%.

  • 55% of the women were at MODERATE risk of recurrence
  • 52% of the women were at MODERATE risk of a serious heart problem

Moderate risk meant that the women's risk of recurrence or having a heart problem in 10 years was 10%-25%.

  • 42% of the women were at LOW risk of recurrence
  • 36% of the women were at LOW risk of a serious heart problem

Low risk meant that the women's risk of recurrence or having a heart problem in 10 years was less than 10%.

While it's likely that all of the women in the study were very aware of their risk of recurrence, it's also likely that many of them were less aware of their risk of heart problems. Still, this study shows that most of the women were as likely or even more likely to have a serious heart problem as recurrence. Only 22% of the women had a risk of recurrence that was higher than their risk of heart problems.

The researchers didn't identify any links between breast cancer and the risk of heart problems. But it is possible that there may be a relationship between certain breast cancer treatments and the risk of heart problems. Radiation therapy and some chemotherapy and targeted therapy medicines can injure the heart. Still, most of the cardiac risk was likely related to other health factors -- high blood pressure or high cholesterol, for example -- that increase the risk of heart problems in ALL people, whether or not they were treated for breast cancer.

If you've been diagnosed with breast cancer, work with your doctor to keep all health risks, including the risk of recurrence and heart problems, as low as they can be. Adopting a heart healthy lifestyle is important for everyone, but it's especially important for people diagnosed with breast cancer. You can't change the fact that you need treatment. But you can reduce your risk of both recurrence and cardiac disease by changing factors you can control:

  • Eat a diet low in fat and with generous amounts of fruits and vegetables.
  • Maintain a healthy weight.
  • Exercise regularly at a moderately strenuous level.
  • Don't smoke.
  • Avoid alcohol.
  • Monitor your blood pressure and cholesterol levels and stick to any treatments your doctor prescribes for these conditions.
  • If you have diabetes, work with your doctor to manage your condition in the best way possible.

It's also very important that you regularly see a doctor who's familiar with your breast cancer treatment history and understands any special risks you have. Together, you can come up with a counseling, monitoring, and screening plan that is best for your unique situation.

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