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Breast Cancer Treatment Linked to Increased Risk of Diabetes and High Blood Pressure

Women with a history of invasive breast cancer had a higher risk of developing high blood pressure and diabetes than women without a history of breast cancer.
May 26, 2022.
 

Women with a history of invasive breast cancer had a higher risk of developing high blood pressure and diabetes than women without a history of breast cancer, according to a study.

The research was published in the May 20, 2022, issue of the Journal of Clinical Oncology. Read the abstract of “Risk of Cardiometabolic Risk Factors in Women With and Without a History of Breast Cancer: The Pathways Heart Study.”

 

Breast cancer and cardiometabolic disorders

The term cardiometabolic disorders refers to a group of interrelated conditions that increase people’s risk of developing heart disease or type 2 diabetes. These conditions, which doctors consider risk factors, include:

  • high blood pressure

  • high fasting blood sugar

  • high cholesterol

  • excess belly fat

  • high triglycerides

A number of breast cancer treatments, including radiation, chemotherapy, targeted therapy, and hormonal therapy, can cause heart problems. Research shows that women with a history of breast cancer have a higher risk of heart disease than women without a history of breast cancer. Research also shows that heart disease is the most common cause of death — outside of cancer — for women with a history of breast cancer.

In this study, the researchers wanted to see if women with a history of breast cancer had higher rates of certain cardiometabolic disorders than women without a history of breast cancer.

 

About the study

Called the Pathways Heart Study, this ongoing study is looking at rates of heart disease and cardiometabolic risk factors in women with and without a history of breast cancer.

For this analysis, the researchers matched 14,942 women who had been diagnosed with stage I to stage IV breast cancer between November 2005 and March 2013 with 74,702 women with no history of breast cancer. All the women were from Northern California and had Kaiser Permanente health insurance.

The women were matched based on:

  • age

  • race

  • ethnicity

The women’s average age was 61.2 and:

  • 65% of the women were white

  • 7% of the women were Black

  • 14% of the women were Asian

  • 12% of the women were Hispanic

  • 1% of the women were American Indian or Alaska Native

The researchers looked at the women’s health records for a variety of information, including how many women had been diagnosed with three cardiometabolic conditions:

  • high blood pressure

  • diabetes

  • high cholesterol

The researchers also looked at the treatments women who’d been diagnosed with breast cancer had received.

Women with a history of breast cancer were more likely than women without a history of breast cancer to be:

  • former smokers

  • considered overweight or obese

During an average follow-up time of seven years:

  • 11.9% of women with a history of breast cancer developed high blood pressure

  • 12.7% of women with no history of breast cancer developed high blood pressure

  • 6.7% of women with a history of breast cancer developed diabetes

  • 6% of women with no history of breast cancer developed diabetes

  • 11.8% of women with a history of breast cancer developed high cholesterol

  • 12.9% of women with no history of breast cancer developed high cholesterol

Overall, the researchers found that women with a history of breast cancer were more likely to develop diabetes than women with no history of breast cancer.

The researchers looked at cardiometabolic risk factor rates in women who had received specific treatments and found that women who’d received left-side radiation or hormonal therapy had an increased risk of high blood pressure.

“We suspected that cardiometabolic health problems might be common among breast cancer survivors,” the study’s lead author Marilyn L. Kwan, PhD, senior research scientist at the Kaiser Permanente Division of Research, said in a statement. “Our study is one of the largest to date to focus on the specific cardiometabolic problems these women are at risk for and the specific cancer treatments that may increase their risk.

“Identifying this risk is the first step in improving health outcomes in our breast cancer patients,” Dr. Kwan added. “Now, we want to look more closely at the best interventions that health systems can make to reduce this risk.”

 

What this means for you

If you’ve been diagnosed with invasive breast cancer, the results of this study are concerning. Still, we do know there are steps you can take to keep your risk of diabetes and high blood pressure, as well as heart disease, as low as possible.

Exercise during and after breast cancer treatment has been shown to:

  • improve quality of life

  • reduce anxiety

  • reduce the risk of heart problems

  • ease depression

  • lessen fatigue

  • improve physical function

  • help maintain a healthy weight

Each of those benefits — individually or combined — can help reduce the risk of diabetes and high blood pressure.

A survivorship care plan also can help you stay on top of regular screenings for high blood pressure, heart disease, diabetes, and osteoporosis — conditions that many breast cancer survivors have a higher risk of developing as they get older.

“Sometimes patients put other health conditions to the side and focus on their breast cancer,” study co-author Dawn Hershman, MD, MS, director of the Breast Cancer Program at Columbia University Medical Center, said in a statement. Dr. Hershman is also a member of the Breastcancer.org Professional Advisory Board. “It is important for them to know that they are at risk for these other health problems, that their risk may be higher either from the treatment or the physical consequences of being diagnosed, and that they should do as much as they can to prevent weight gain, exercise, stay adherent to all of their medications, and follow up with their other healthcare providers.”

If you’ve finished breast cancer treatment and nobody has discussed a survivorship care plan with you, it’s a good idea to ask your oncologist:

  • for a survivorship care plan in writing that explains all the medical issues you need to consider and includes all the screening tests you need and when you should have them

  • which doctor you should see for each medical issue

  • for a referral, if your oncologist recommends you see a specialist — a cardiologist for example — and you’ve never seen one before

  • to explain anything in your survivorship care plan that you don’t understand

  • which parts of your survivorship care plan your primary care doctor is responsible for

Learn more about Before Treatment: Planning Ahead for Survivorship.

Written by: Jamie DePolo, senior editor

— Last updated on June 16, 2022, 9:22 PM

Reviewed by 1 medical adviser
 
Brian Wojciechowski, MD
Crozer Health System, Philadelphia area, PA
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