The dangerous intersection of breast cancer and cardiovascular disease
December 18, 2024This article by Evolent’s Terra Wonsettler, PharmD, MBA, was originally published in the December issue of American Journal of Managed Care’s Evidence-Based Oncology.
Every 14 seconds, somewhere in the world, a woman is diagnosed with breast cancer. It is the most common cancer worldwide, with over 2.3 million diagnosed per year. There are approximately 4.1 million female breast cancer survivors in the United States, representing over one-fifth of all cancer survivors in the nation. Yet there are more strides to be made, as breast cancer is the second leading cause of cancer deaths, following lung cancer.
Meanwhile, cardiovascular disease (CVD) remains the leading cause of mortality among women and often intersects with breast cancer. This connection is most prominent in those undergoing treatments such as anthracyclines or HER2-targeted cancer therapy, due to their cardiotoxic effects. Furthermore, breast cancer survivors with CVD have a 1.24-fold higher risk of dying than those without a history of CVD. The junction between breast cancer and CVD underscores the importance of an integrated approach to improve overall survival rates and quality of life, especially as chemotherapy and radiation can lead to cardiotoxicity, exacerbating cardiovascular conditions and contributing to poorer survival rates.
This intersection becomes even more critical when considering gaps in health equity such as racial disparities, socioeconomic status, and geographic location. For instance, Black women in the United States are more likely to die from breast cancer than their White counterparts, despite having a lower incidence rate. Patients from lower socioeconomic backgrounds experience worse cardiovascular outcomes. Research shows that breast cancer survivors living in rural areas face a 24% higher risk of cardiovascular mortality than those in urban areas.
The high prevalence and mortality rates of breast cancer, coupled with adverse CVD effects of treatments and pervasive disparities, highlight the urgency for an encompassing, equitable clinical framework….