Male Breast Cancer Patients Face High Prevalence of CV Disease Risk Factors

Male breast cancer patients may have a high prevalence of cardiovascular conditions, according to a small study of this rare patient population which will be presented as part of ACC's Advancing the Cardiovascular Care of the Oncology Patient Virtual course, taking place Feb. 5 – 6.

Researchers from Georgetown Lombardi Comprehensive Cancer and MedStar Washington Hospital Center in Washington, DC, conducted a retrospective chart review of 24 male breast cancer patients evaluated at the medical centers. The patients were between 38 and 79 years old with 42% being African American, 29% being Caucasian, 4% Hispanic and 25% another ethnicity. Half of the patients had a family history of breast cancer.

The majority of patients – 79% – had invasive ductal carcinoma. All patients underwent a mastectomy, while 4% received anthracycline chemotherapy, 8% received human epidermal growth factor receptor 2 (HER2)-targeted therapy, 16% received radiation and 71% received hormone therapy. Six patients were diagnosed with a secondary primary malignancy and three with a third primary malignancy.

Researchers also found 88% of patients were overweight, 58% had high blood pressure and 54% had high cholesterol. Tachyarrhythmia preexisted in 8% of patients and developed in 13% of patients while undergoing treatment. Two patients were found to have decreased ejection fraction, and two patients developed heart failure after treatment.

According to the researchers, the high prevalence of cardiovascular conditions in male breast cancer patients requires further investigation to better understand the risk of preexisting heart disease on long-term outcomes for these patients. The findings also highlight the need for cardiologists and cardio-oncologists to be involved in male breast cancer treatment due to the common risk factors and potential cardiotoxic effects of breast cancer treatment.

"Due to the rarity of male breast cancer, there is no cardiovascular data from larger clinical trials or population studies," explains Michael Ibrahim, fourth year medical student at Georgetown University and one of the study authors. "The lack of large data makes it even more important to individualize cardiovascular assessment and management based on each patient's unique oncologic, therapeutic and preexisting cardiovascular risk profile to support them through cancer treatment into survivorship."

Ibrahim adds, "The field of cardio-oncology is well positioned to ensure that cardiologists and oncologists work closely together to address both the patients' oncologic and cardiac concerns. Cardio-oncologists or cardiologists should pay close attention to the proposed treatment plan and be part of a multidisciplinary cancer care team to evaluate the patients' cardiovascular risk prior to and through cancer treatments. On a more personal level, cancer patients are already surprised by their cancer diagnosis. Similar to the pretreatment consultation with radiation oncology, breast surgery, and medical oncology, an upfront cardiovascular risk assessment provides greater comfort and further minimizes psychological surprise with cardiovascular complications going into cancer treatment."

ACC's Advancing the Cardiovascular Care of the Oncology Patient Virtual course features cardiology and oncology experts providing clinically relevant, best practice strategies for a multidisciplinary team regarding the assessment, diagnosis and management of cardiovascular concerns for cancer patients, as well as those requiring survivorship care.

Other abstracts being presented at the meeting include:

  • Cardiovascular Outcomes Associated with Chemotherapy and Targeted Therapies in Adolescent and Young Adult Cancer Survivors
  • Risk of Cardiotoxicity with Dual HER2 Targeted Therapies in Breast Cancer
  • The Association of Physical Activity, Cardiac and Patient-Reported Outcomes in HER2+ Breast Cancer Survivors During Therapy

Don't miss a fireside chat and a pre-conference Q/A webinar on Feb. 5, as well as the livestream conference on Feb. 6. On-demand access to sessions and additional content will be available through April 25. Also stay up to date throughout the course via social media by using the hashtag #CardioOnc and following @ACCinTouch.

Clinical Topics: Arrhythmias and Clinical EP, Cardio-Oncology, Diabetes and Cardiometabolic Disease, Dyslipidemia, Heart Failure and Cardiomyopathies, Prevention, SCD/Ventricular Arrhythmias, Atrial Fibrillation/Supraventricular Arrhythmias, Lipid Metabolism, Nonstatins, Acute Heart Failure, Exercise, Hypertension

Keywords: Anthracyclines, Cardiotoxicity, Breast Neoplasms, Male, Cardiovascular Diseases, African Americans, Ethnic Groups, Stroke Volume, Radiation Oncology, Mastectomy, Risk Factors, Neoplasms, Heart Diseases, Exercise, Heart Failure, Cardiology, Hypertension, Referral and Consultation, Hispanic Americans, Hospitals, Tachycardia, Overweight, Patient Care Team, Carcinoma, Ductal, Cholesterol, Hormones

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