Abstract
BACKGROUND: Few studies have examined the relationship between cardiometabolic risk factors linked to metabolic syndrome and mortality among women with breast cancer. METHODS: We used the Women's Health Initiative to evaluate the relationship between cardiometabolic risk factors, including waist circumference (WC), blood pressure, cholesterol level, and presence of type 2 diabetes, and their relation with death from breast cancer, cardiovascular disease (CVD), and other causes among 8641 women with local or regional stage invasive breast cancer. Cox proportional hazards models were used to estimate hazard ratios, and 95% confidence intervals, adjusted for important predictors of survival. RESULTS: After a median of 11.3 years, there were 2181 total deaths, 619 (28.4%) of which were due to breast cancer. Most participants (55.7%) had at least 2 cardiometabolic risk factors, and 4.9% had 3 or 4. Having a larger number of risk factors was associated with higher risk of CVD and other-cause mortality (P trend <.001 for both), but not with breast cancer mortality (P trend =.86). Increased WC was associated with a higher risk of CVD (hazard ratio [HR], 1.28; 95% confidence interval [CI], 1.05-1.57) and other-cause mortality (HR, 1.32; 95% CI, 1.16-1.49) and only with a small and nonsignificant higher risk of breast cancer mortality (HR, 1.19; 95% CI, 0.93-1.52). The results did not differ in analyses stratified by race, hormone receptor status, or after an analysis of cases diagnosed within 5 years after baseline. CONCLUSIONS: Among women with early stage breast cancer, cardiometabolic risk factors are significantly associated with cardiovascular and other-cause mortality, but not breast cancer mortality. Cancer 2018;124:1798-807.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 1798-1807 |
| Number of pages | 10 |
| Journal | Cancer |
| Volume | 124 |
| Issue number | 8 |
| DOIs | |
| State | Published - Apr 15 2018 |
| Externally published | Yes |
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Keywords
- breast cancer
- cardiometabolic risk factors
- survival
- Women's Health Initiative
ASJC Scopus subject areas
- Oncology
- Cancer Research
Cite this
Cardiometabolic risk factors and survival after breast cancer in the Women's Health Initiative. / Simon, Michael S.; Beebe-Dimmer, Jennifer L.; Hastert, Theresa A.; Manson, Jo Ann E.; Cespedes Feliciano, Elizabeth M.; Neuhouser, Marian L.; Ho, Gloria Y.F.; Freudenheim, Jo L.; Strickler, Howard; Ruterbusch, Julie; Barac, Ana; Chlebowski, Rowan; Caan, Bette.
In: Cancer, Vol. 124, No. 8, 15.04.2018, p. 1798-1807.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Cardiometabolic risk factors and survival after breast cancer in the Women's Health Initiative
AU - Simon, Michael S.
AU - Beebe-Dimmer, Jennifer L.
AU - Hastert, Theresa A.
AU - Manson, Jo Ann E.
AU - Cespedes Feliciano, Elizabeth M.
AU - Neuhouser, Marian L.
AU - Ho, Gloria Y.F.
AU - Freudenheim, Jo L.
AU - Strickler, Howard
AU - Ruterbusch, Julie
AU - Barac, Ana
AU - Chlebowski, Rowan
AU - Caan, Bette
PY - 2018/4/15
Y1 - 2018/4/15
N2 - BACKGROUND: Few studies have examined the relationship between cardiometabolic risk factors linked to metabolic syndrome and mortality among women with breast cancer. METHODS: We used the Women's Health Initiative to evaluate the relationship between cardiometabolic risk factors, including waist circumference (WC), blood pressure, cholesterol level, and presence of type 2 diabetes, and their relation with death from breast cancer, cardiovascular disease (CVD), and other causes among 8641 women with local or regional stage invasive breast cancer. Cox proportional hazards models were used to estimate hazard ratios, and 95% confidence intervals, adjusted for important predictors of survival. RESULTS: After a median of 11.3 years, there were 2181 total deaths, 619 (28.4%) of which were due to breast cancer. Most participants (55.7%) had at least 2 cardiometabolic risk factors, and 4.9% had 3 or 4. Having a larger number of risk factors was associated with higher risk of CVD and other-cause mortality (P trend <.001 for both), but not with breast cancer mortality (P trend =.86). Increased WC was associated with a higher risk of CVD (hazard ratio [HR], 1.28; 95% confidence interval [CI], 1.05-1.57) and other-cause mortality (HR, 1.32; 95% CI, 1.16-1.49) and only with a small and nonsignificant higher risk of breast cancer mortality (HR, 1.19; 95% CI, 0.93-1.52). The results did not differ in analyses stratified by race, hormone receptor status, or after an analysis of cases diagnosed within 5 years after baseline. CONCLUSIONS: Among women with early stage breast cancer, cardiometabolic risk factors are significantly associated with cardiovascular and other-cause mortality, but not breast cancer mortality. Cancer 2018;124:1798-807.
AB - BACKGROUND: Few studies have examined the relationship between cardiometabolic risk factors linked to metabolic syndrome and mortality among women with breast cancer. METHODS: We used the Women's Health Initiative to evaluate the relationship between cardiometabolic risk factors, including waist circumference (WC), blood pressure, cholesterol level, and presence of type 2 diabetes, and their relation with death from breast cancer, cardiovascular disease (CVD), and other causes among 8641 women with local or regional stage invasive breast cancer. Cox proportional hazards models were used to estimate hazard ratios, and 95% confidence intervals, adjusted for important predictors of survival. RESULTS: After a median of 11.3 years, there were 2181 total deaths, 619 (28.4%) of which were due to breast cancer. Most participants (55.7%) had at least 2 cardiometabolic risk factors, and 4.9% had 3 or 4. Having a larger number of risk factors was associated with higher risk of CVD and other-cause mortality (P trend <.001 for both), but not with breast cancer mortality (P trend =.86). Increased WC was associated with a higher risk of CVD (hazard ratio [HR], 1.28; 95% confidence interval [CI], 1.05-1.57) and other-cause mortality (HR, 1.32; 95% CI, 1.16-1.49) and only with a small and nonsignificant higher risk of breast cancer mortality (HR, 1.19; 95% CI, 0.93-1.52). The results did not differ in analyses stratified by race, hormone receptor status, or after an analysis of cases diagnosed within 5 years after baseline. CONCLUSIONS: Among women with early stage breast cancer, cardiometabolic risk factors are significantly associated with cardiovascular and other-cause mortality, but not breast cancer mortality. Cancer 2018;124:1798-807.
KW - breast cancer
KW - cardiometabolic risk factors
KW - survival
KW - Women's Health Initiative
UR - http://www.scopus.com/inward/record.url?scp=85045137122&partnerID=8YFLogxK
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U2 - 10.1002/cncr.31230
DO - 10.1002/cncr.31230
M3 - Article
VL - 124
SP - 1798
EP - 1807
JO - Cancer
JF - Cancer
SN - 0008-543X
IS - 8
ER -