Guan Tianwang, Zhang Hanbin, Yang Jinming, Lin Wenrui, Wang Kenie, Su Miao, Peng Weien, Li Yemin, Lai Yanxian, Liu Cheng
Department of Cardiology, Guangzhou First People's Hospital, South China University of Technology, Guangzhou, China.
Department of Cardiology, Guangzhou First People's Hospital, Guangzhou Medical University, Guangzhou, China.
Front Oncol. 2021 Jan 28;10:619622. doi: 10.3389/fonc.2020.619622. eCollection 2020.
Cardiovascular death (CVD) in breast cancer patients without chemotherapy (CT) or (and) radiotherapy (RT) has not been studied yet. This study evaluates the correlation between breast cancer and CVD risk independent of chemotherapy or (and) radiotherapy.
Data of female breast cancer patients without receiving CT or RT were retrieved from the Surveillance, Epidemiology, and End Result (SEER) database (2004-2015). Data were divided into two cohorts: tumor resection cohort and no resection cohort. The CVD risk in patients was expressed as standardized mortality ratios (SMRs). A 1:1 propensity score matching (PSM) was applied to balance inter-group bias, and competing risk regressions were utilized to evaluate the impact of tumor resection on CVD.
The CVD risk was significantly higher (SMR = 2.196, 95% CI: 2.148-2.245, <0.001) in breast cancer patients who did not receive CT or RT compared to the general population. Breast cancer patients without tumor resection showed higher CVD risk than patients who underwent tumour resection (tumor resection SMR = 2.031, 95% CI: 1.983-2.079, <0.001; no resection SMR = 5.425, 95% CI: 5.087-5.781, <0.001). After PSM, the CVD risk among patients without tumor resection indicated an increase of 1.165-fold compared to patients with tumor resection (HR=1.165, 95% CI: 1.039-1.306, =0.009).
Female breast cancer patients are at higher risk of CVD despite unexposure to cardio-toxic CT or RT. However, female breast cancer patients subjected to tumor resection have decreased CVD risk. These results indicated that monitoring female breast cancer patients not receiving RT or CT might serve as a preventative measure against CVD.
尚未对未接受化疗（CT）或（和）放疗（RT）的乳腺癌患者的心血管死亡（CVD）进行研究。本研究评估了独立于化疗或（和）放疗的乳腺癌与CVD风险之间的相关性。
从监测、流行病学和最终结果（SEER）数据库（2004 - 2015年）中检索未接受CT或RT的女性乳腺癌患者的数据。数据分为两个队列：肿瘤切除队列和未切除队列。患者的CVD风险以标准化死亡率（SMR）表示。应用1:1倾向评分匹配（PSM）来平衡组间偏差，并使用竞争风险回归来评估肿瘤切除对CVD的影响。
与一般人群相比，未接受CT或RT的乳腺癌患者的CVD风险显著更高（SMR = 2.196，95% CI：2.148 - 2.245，<0.001）。未进行肿瘤切除的乳腺癌患者显示出比接受肿瘤切除的患者更高的CVD风险（肿瘤切除SMR = 2.031，95% CI：1.983 - 2.079，<0.001；未切除SMR = 5.425，95% CI：5.087 - 5.781，<0.001）。PSM后，未进行肿瘤切除的患者的CVD风险比进行肿瘤切除的患者增加了1.165倍（HR = 1.165，95% CI：1.039 - 1.306，= 0.009）。
尽管未接触心脏毒性的CT或RT，女性乳腺癌患者仍有较高的CVD风险。然而，接受肿瘤切除的女性乳腺癌患者的CVD风险降低。这些结果表明，监测未接受RT或CT的女性乳腺癌患者可能是预防CVD的一项措施。
