Cardiovascular events and mortality in a population-based cohort initially diagnosed with ductal carcinoma in situ

Cardiovascular outcomes in breast cancer survivors: a systematic review and meta-analysis

AIMS

It is unclear whether the future risk of cardiovascular events in breast cancer (Bc) survivors is greater than in the general population. This meta-analysis quantifies the risk of cardiovascular disease development in Bc patients, compared to the risk in a general matched cancer-free population, and reports the incidence of cardiovascular events in patients with Bc.

METHODS AND RESULTS

We searched PubMed, Scopus, and Web of Science databases (up to 23 March 2022) for observational studies and post hoc analyses of randomized controlled trials. Cardiovascular death, heart failure (HF), atrial fibrillation (AF), coronary artery disease (CAD), myocardial infarction (MI), and stroke were the individual endpoints for our meta-analysis. We pooled incidence rates (IRs) and risk in hazard ratios (HRs), using random-effects meta-analyses. Heterogeneity was reported through the I2 statistic, and publication bias was examined using funnel plots and Egger's test in the meta-analysis of risk. One hundred and forty-two studies were identified in total, 26 (836 301 patients) relevant to the relative risk and 116 (2 111 882 patients) relevant to IRs. Compared to matched cancer-free controls, Bc patients had higher risk for cardiovascular death within 5 years of cancer diagnosis [HR = 1.09; 95% confidence interval (CI): 1.07, 1.11], HF within 10 years (HR = 1.21; 95% CI: 1.1, 1.33), and AF within 3 years (HR = 1.13; 95% CI: 1.05, 1.21). The pooled IR for cardiovascular death was 1.73 (95% CI 1.18, 2.53), 4.44 (95% CI 3.33, 5.92) for HF, 4.29 (95% CI 3.09, 5.94) for CAD, 1.98 (95% CI 1.24, 3.16) for MI, 4.33 (95% CI 2.97, 6.30) for stroke of any type, and 2.64 (95% CI 2.97, 6.30) for ischaemic stroke.

CONCLUSION

Breast cancer exposure was associated with the increased risk for cardiovascular death, HF, and AF. The pooled incidence for cardiovascular endpoints varied depending on population characteristics and endpoint studied.

REGISTRATION

CRD42022298741.

Breast cancer in Trinidad and Tobago: Etiopathogenesis, histopathology and receptor study

Background:

Breast Carcinoma (BCa) is the leading cause of cancer among females in Trinidad and Tobago (TnT). This twin-island has a diversified population of 1.3 million individuals that display and are exposed to a variety of lifestyle choices that have been linked to the development of BCa. Therefore, this study aimed to identify the risk factors that influence the development of BCa, analyze the common histopathological details, and categorize BCa based on receptor study.

Methods:

Cancer information for 120 BCa cases at Eric Williams Medical Sciences Complex from 2012 to 2019 was retrieved, analyzed, and statistically estimated. The clinical details were categorized based on data tabulations, and histological assessment was performed to identify specific features. The receptor analysis was classified based on estrogen receptor (ER), progesterone receptor (PR), and human epidermal growth factor-2 (HER-2neu) staining intensity. A descriptive data analysis and comparison were statistically evaluated in all these cases.

Results:

Epidemiological factors influencing the development of BCa were age with a peak of 56–65 years 27.5% (n = 33), ethnicity predominated in Indo-Trinidadians 48.33% (n = 58), and marital status primarily in unmarried/single/widowed patients 55% (n = 66). Infiltrating ductal carcinoma was the principal histopathological type 91.66% (n = 110). Receptor analysis revealed ER/PR + HER-2neu as the most common type 40% (n = 18) for therapeutic surveillance.

Conclusion:

This study highlights various epidemiological factors that influence the development of BCa among females in TnT. Histopathological analysis and receptor studies would provide a useful link between the tumor behavior and its prognosis.