Breast cancer survivors have increasing stroke risk with survivorship
Breast cancer survivors saw increasing risk of stroke along with growing duration of survivorship, particularly during the post-menopausal period, according to a study presented at ISC 2019.
Using data from the Massey Cancer Registry, researchers identified 2,141 post-menopausal breast cancer survivors (mean age 64 years), of whom 616 women had a complete data for Framingham Stroke Risk Score (FSRS) equation, such as age, gender, systolic blood pressure (SBP, >140 mm Hg), presence of cardiovascular disease (CVD), left ventricular hypertrophy, smoking status, atrial fibrillation, and occurrence of diabetes. The FSRS was used to determine the probability and risk factors of having a stroke after survival. [ISC 2019, abstract WP480]
At diagnosis, patients showed an average FSRS of 10.60, “corresponding to a 6 percent probability of having a stroke in the next 10 years,” said lead author Associate Professor Kyungeh An from the Department of Nursing at Virginia Commonwealth University in Richmond, Virginia, US.
A substantial increase in FSRS from 10.60 to 16.07 was observed within the first year of survival among post-menopausal breast cancer survivors . FSRS also increased at 5 and 10 years, but the increases were smaller relative to the first year (FSRS, 17.27 and 17.76 at year 5 and 10,respectively).
Furthermore, breast cancer survivors who underwent hormonal therapy had a significantly higher FSRS than those who did not (15.88 vs 8.17; p=0.000), while tumour status had no effect on the FSRS.
In the population of survivors who were non-Hispanic, FSRS was significantly higher among African Americans compared with Caucasians (12.55 vs 9.25; p=0.016).
Systolic BP was the most common risk factor for stroke at 43.3 percent, followed by the presence of CVD marker at 39.56 percent and diabetes at 23.11 percent.
“Cancer is a well-known risk factor for stroke … Stroke risk consistently increases along with the survivorship of a breast cancer, particularly among women after their menopause,” noted Kyungeh, who highlighted that “prevention and control of high BP and diabetes should be a target of intervention to reduce the stroke risk among post-menopausal breast cancer survivors.”