Subramaniam, Shridevi and Kong, Yek-Ching and Zaharah, Hafizah and Uiterwaal, Cuno S. P. M. and Richard, Andrea and Tab, Nur Aishah and Deniel, Azura and Chee, Kok-Han and Bustamam, Ros Suzanna and See, Mee-Hoong and Fong, Alan and Yip, Cheng-Har and Bhoo-Pathy, Nirmala (2021) Baseline cardiovascular comorbidities, and the influence on cancer treatment decision-making in women with breast cancer. Ecancermedicalscience, 15. ISSN 1754-6605, DOI https://doi.org/10.3332/ecancer.2021.1293.
Full text not available from this repository.Abstract
Purpose: To measure the baseline prevalence of cardiovascular disease (CVD), its modifiable and non-modifiable risk factors in breast cancer patients, and determine their association with adjuvant treatment decision-making. Method: From 2016 to 2017, 2,127 women newly-diagnosed with breast cancer were prospectively recruited. Participants' cardiovascular biomarkers were measured prior to adjuvant treatment decision-making. Clinical data and medical histories were obtained from hospital records. Adjuvant treatment decisions were collated 6-8 months after recruitment. A priori risk of cardiotoxicity was predicted using the Cardiotoxicity Risk Score. Results: Mean age was 54 years. Eighty-five patients had pre-existing cardiac diseases and 30 had prior stroke. Baseline prevalence of hypertension was 47.8%. Close to 20% had diabetes mellitus, or were obese. Dyslipidaemia was present in 65.3%. The proportion of women presenting with 1.2 modifiable CVD risk factors at initial cancer diagnosis was substantial, irrespective of age. Significant ethnic variations were observed. Multivariable analyses showed that pre-existing CVD was consistently associated with lower administration of adjuvant breast cancer therapies (odds ratio for chemotherapy: 0.32, 95% confidence interval: 0.17-0.58). However, presence of multiple risk factors of CVD did not appear to influence adjuvant treatment decision-making. In this study, 63.6% of patients were predicted to have high risks of developing cardiotoxicities attributed to a high baseline burden of CVD risk factors and anthracycline administration. Conclusion: While recent guidelines recommend routine assessment of cardiovascular comorbidities in cancer patients prior to initiation of anticancer therapies, this study highlights the prevailing gap in knowledge on how such data may be used to optimise cancer treatment decision-making.
| Item Type: | Article |
|---|---|
| Funders: | None |
| Uncontrolled Keywords: | Breast cancer; Cardiovascular risk factors; Cardiotoxicity |
| Subjects: | R Medicine > RC Internal medicine R Medicine > RC Internal medicine > RC0254 Neoplasms. Tumors. Oncology (including Cancer) |
| Divisions: | Faculty of Medicine |
| Depositing User: | Ms Zaharah Ramly |
| Date Deposited: | 19 May 2022 01:19 |
| Last Modified: | 19 May 2022 01:19 |
| URI: | http://eprints.um.edu.my/id/eprint/34808 |
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