Relationship between incident cardiovascular disease and quality of life after a breast cancer diagnosis

Alexi Vasbinder, Department of Biobehavioral Nursing and Health Informatics, University of Washington School of Nursing, 1959 NE Pacific St, Box 357266, Seattle, WA, 98195, USA. avasbind@uw.edu.
Elena Wadden, Department of Medicine, University of Washington, Seattle, WA, USA.
Richard K. Cheng, Division of Cardiology, University of Washington, Seattle, WA, USA.
Ana Barac, Inova Schar Heart and Vascular, Inova Schar Cancer, Fairfax, VA, USA.
Christopher R. Friese, Rogel Cancer Center, School of Nursing and Public Health, University of Michigan, Ann Arbor, MI, USA.
Yangbo Sun, Department of Preventive Medicine, The University of Tennessee Health Science Center, Memphis, TN, USA.
Aladdin H. Shadyab, Herbert Wertheim School of Public Health and Human Longevity Science and Division of Geriatrics, Gerontology, and Palliative Care, Department of Medicine, University of California San Diego, La Jolla, CA, USA.
Longjian Liu, Department of Epidemiology and Biostatistics, Dornsife School of Public Health, Drexel University, Philadelphia, PA, USA.
Lisa Warsinger Martin, Division of Cardiology, School of Medicine and Health Sciences, George Washington University, Washington, DC, USA.
Marcia Stefanick, Stanford Prevention Research Center, School of Medicine, Stanford University, Stanford, CA, USA.
Michael S. Simon, Department of Oncology, Karmanos Cancer Institute at Wayne State University, Detroit, MI, USA.
Kerryn Reding, Department of Biobehavioral Nursing and Health Informatics, University of Washington School of Nursing, 1959 NE Pacific St, Box 357266, Seattle, WA, 98195, USA.

Document Type

Journal Article

Publication Date

2-6-2025

Journal

Journal of cancer survivorship : research and practice

DOI

10.1007/s11764-025-01757-w

Keywords

Breast cancer; Cardiovascular disease; Quality of life; Short-form 36; Survivor

Abstract

PURPOSE: Breast cancer survivors are at risk for both poor quality of life (QoL) and cardiovascular disease (CVD). This study examines whether incident CVD after breast cancer independently predicts QoL. METHODS: Using data from the Women's Health Initiative, we included women who were diagnosed with invasive breast cancer during follow-up and free of prevalent CVD prior to breast cancer. CVD was defined as adjudicated coronary heart disease, heart failure, or stroke. Physical and mental QoL, measured by the SF-36 Physical and Mental Component Scores (PCS and MCS, respectively), were recorded after breast cancer. Poor PCS and MCS were defined as scores < 40. We used adjusted time-dependent Cox proportional hazards models, accounting for time to CVD. RESULTS: Among 2912 BC survivors (mean age at BC diagnosis = 67), 1094 (37.6%) and 313 (10.7%) women had a post-breast cancer PCS and MCS score < 40, respectively, at a median of 2.5 years. A higher proportion of women had poor PCS scores post-BC (37.5% vs. 19.2%, P < 0.001) but not MCS (10.4% vs. 8.2%, P = 0.10). After adjustment for key covariates, incident CVD was associated with a 1.95-fold (95% CI 1.42, 2.67) greater risk of poor PCS scores (P < 0.001), but was not associated with poor MCS (HR 1.23, 95% CI 0.57, 2.65, P = 0.59)). CONCLUSIONS: Incident CVD after breast cancer was associated with poor physical QoL but not mental QoL. IMPLICATIONS FOR CANCER SURVIVORS: This study highlights the importance of regular assessments of QoL and need for strategies to improve physical QoL in breast cancer survivors with CVD.

Department

Medicine

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