Luo Yunbo, Zhao Long, Qu Peng, Han Shiqi, Wang Yali, Li Xue, Liu Jun, Ma Cui, Deng Shishan, Liang Qi, Hou Lingmi, Cheng Panke
Department of Breast Surgery, Plastic Surgery, Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, School of Medicine, University of Electronic Science and Technology of China, Chengdu, 610041, Sichuan, P.R. China.
Department of Academician (expert) Workstation, Biological Targeting Laboratory of Breast Cancer, Breast and Thyroid Surgery, Affiliated Hospital of North Sichuan Medical College, Nanchong, 637000, Sichuan, P.R. China.
Sci Rep. 2025 Aug 2;15(1):28228. doi: 10.1038/s41598-025-12648-6.
With the improvement of comprehensive anti-cancer treatment for breast cancer (BC), more and more BC survivors will die from non-cancer diseases, including cardiovascular disease dominated by heart disease (HD). Therefore, this study aimed to analyze the risk of heart-specific death (HSD) in patients with BC by using the Surveillance, Epidemiology, and End Results (SEER) database. The eligible patients diagnosed with BC between 2000 and 2019 were exported from the SEER database. The standard mortality ratios (SMR) were calculated to compare the difference in HSD between patients with BC and the general population. The Cox Proportional hazard model was used to estimate the risk factors for HSD in BC patients and the 95% confidence intervals (CI) were calculated. Overall, 655,552 eligible patients were included in our study, and 149,708 (22.8%) patients died. Among the deaths, 22,718 (15.2%) cases were attributed HD which was the second cause of death for BC patients. With the extension of follow-up (> 10 years), HD surpassed breast cancer as the leading cause of death for BC (22.3% vs. 20.2%). The SMR for HD was 8.14 (95%CI: 8.04-8.25) in the whole cohort. Multivariate analysis showed that race, age, marital status, median household income, grade, stage and subtype were independent risk factors for HSD in BC patients. The risk of HSD is significantly higher in BC patients than in the general population and closely related to demographic characteristics and tumor clinicopathological factors. Medical approaches are needed to reduce the risk of HD among patients with BC.
随着乳腺癌（BC）综合抗癌治疗水平的提高，越来越多的BC幸存者将死于非癌症疾病，包括以心脏病（HD）为主的心血管疾病。因此，本研究旨在利用监测、流行病学和最终结果（SEER）数据库分析BC患者心脏特异性死亡（HSD）的风险。从SEER数据库中导出2000年至2019年间诊断为BC的符合条件的患者。计算标准死亡率（SMR）以比较BC患者与一般人群之间HSD的差异。使用Cox比例风险模型估计BC患者HSD的风险因素，并计算95%置信区间（CI）。总体而言，我们的研究纳入了655552名符合条件的患者，其中149708名（22.8%）患者死亡。在死亡病例中，22718例（15.2%）归因于HD，这是BC患者的第二大死因。随着随访时间的延长（>10年），HD超过乳腺癌成为BC的主要死因（22.3%对20.2%）。整个队列中HD的SMR为8.14（95%CI：8.04 - 8.25）。多因素分析表明，种族、年龄、婚姻状况、家庭收入中位数、分级、分期和亚型是BC患者HSD的独立危险因素。BC患者的HSD风险显著高于一般人群，且与人口统计学特征和肿瘤临床病理因素密切相关。需要采取医学措施降低BC患者的HD风险。
