Abstract P4-10-05: High risk for cardiovascular disease in postmenopausal breast cancer survivors
Authors: Buttros DdAB , Branco MT , Orsatti CL , Nahas-Neto J , Nahas EAP 
Published: May 2019

Background: The majority of women diagnosed with breast cancer are considered to have a good prognosis and can expect to survive the disease. Cardiovascular risk in postmenopausal women treated for breast cancer is higher than in women without cancer.

Objective: To evaluate cardiovascular risk factors in postmenopausal breast cancer survivors, in comparison to postmenopausal women without breast cancer.

Methods: In this cross-sectional study, 96 postmenopausal breast cancer survivors were compared to 192 postmenopausal women (controls), aged 45 to 75 years. The main group included women with amenorrhea &gt; 12 months, aged ≥45 years, with a histological diagnosis of breast cancer, without metastatic disease and without established cardiovascular disease (CVD). The control group consisted of women with amenorrhea &gt; 12 months, aged ≥45 years, without breast cancer and CVD. Groups were matched by age, time since menopause, and body mass index (BMI) in a ration of 1 case to 2 controls, according to sample calculation, with a minimum of 92 breast cancer survivors. Clinical and anthropometric data (BMI and waist circumference) were collected by interview and physical examination. For biochemical analysis, total cholesterol, HLD, LDL, triglycerides, glucose and insulin levels were measured. Women presenting with three or more of the following criteria were diagnosed with metabolic syndrome (MetS): waist circumference (WC)&gt; 88 cm; TG≥ 150 mg/dL; HDL cholesterol &lt;50 mg/dL; blood pressure ≥ 130/85 mmHg; glucose ≥ 100 mg/dL. For measurement of plasma HSP 60 and 70 concentrations, immunoassays were used (ELISA test). Atherosclerotic disease was determined by intima-media thickness (IMT&gt; 1 mm) of the carotid arteries and / or by the presence of atheromatous plaque, assessed by carotid artery ultrasound (scanner duplex). For statistical analysis, Student's t-test, Gamma Distribution (asymmetric variables), Chi-Square Test and Logistic Regression (odds ratio-OR) were used.

Results: Breast cancer survivors had high mean systolic and diastolic blood pressure (p &lt;0.001), and mean blood triglycerides and glucose, above desirable levels (p &lt;0.05). Breast cancer patients had higher HSP60 levels and lower HSP70 levels than controls (p &lt;0.05). Atheromatous plaque occurred more frequently in breast cancer survivors than in controls (19.8% vs. 9.4% respectively) (p &lt;0.05). Analysis of risk adjusted for age, time since menopause and BMI, showed that women treated for breast cancer have a significantly higher risk of MetS (OR = 4.21, 95% CI 2.28-7.76), atheromatous plaque (OR = 2.61, 95% CI 1.19-5.72), diabetes (OR=4.42; 95%CI 1.86- 10.49), hypertriglyceridemia (OR = 2.32, 95% CI 1.33-4.0) and increased waist circumference (OR = 11.22, 95% CI 4.0 - 31.65) than women without breast cancer.

Conclusion: Postmenopausal breast cancer survivors are at higher risk for metabolic syndrome, diabetes, atherosclerotic disease, hypertriglyceridemia and abdominal obesity (major risk factors for cardiovascular disease), in comparison to postmenopausal women without breast cancer.

Citation Format: Buttros DdAB, Branco MT, Orsatti CL, Nahas-Neto J, Nahas EAP. High risk for cardiovascular disease in postmenopausal breast cancer survivors [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr P4-10-05.