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Increased Risk of Heart Diseases in Breast Cancer Survivors

Feb 25, 2020

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Highlights

There is an increased risk of heart failures/diseases in breast cancer survivors, years after the initial diagnosis and treatment of their cancer (long term chemotherapy side effect). Breast cancer patients need to be educated on the negative impacts that cancer treatments like radiotherapy and chemotherapy can have on their cardiovascular health.



Breast cancer is estimated to be the second leading cause of cancer deaths in women in 2020. With the recent advancements in medical treatments and earlier detection, the breast cancer death rates have dropped by 40% from 1989 to 2017 and significantly increased the number of long-term cancer survivors (American Cancer Society, 2020). However, different studies report an increased risk of treatment-related life threatening diseases in cancer survivors, years after the initial diagnosis and treatment. There is overwhelming evidence of non-cancer diseases such as heart disease and cerebrovascular disease contributing to a significant number of deaths of breast cancer patients/survivors, who were previously treated with radiotherapy or chemotherapy (Bansod S et al, Breast Cancer Res Treat. 2020; Ahmed M. Afifi et al, Cancer, 2020).

Increased Risk of Heart Diseases in Breast Cancer Survivors ( Long Term chemotherapy side effect)

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Studies highlighting increased risk of Heart Diseases in Breast Cancer Survivors


With the increasing number of breast cancer survivors, Korean researchers from the SMARTSHIP Group (Study of Multi‐Disciplinary Teamwork for Breast Cancer Survivorship), conducted a nationwide, retrospective study to examine the frequency of occurrence and risk factors associated with congestive heart failure (CHF) in breast cancer patients who survived more than 2 years after the cancer diagnosis (Lee J et al, Cancer, 2020). Congestive heart failure is a chronic condition that occurs when the heart is unable to pump blood around the body properly. The study was conducted with the National Health Information Database of South Korea and included data from a total of 91,227 breast cancer survivor cases and 273,681 controls between January 2007 and December 2013. The researchers found that the risks of congestive heart failure were higher in breast cancer survivors, especially in younger survivors aged lesser than 50 years, than controls. They also found that cancer survivors who were previously treated with chemotherapy drugs like anthracyclines (epirubicin or doxorubicin) and taxanes (docetaxel or paclitaxel) showed a significantly higher risk of heart diseases (Lee J et al, Cancer, 2020).

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In another study published by the researchers from Paulista State University (UNESP), Sao Paulo, Brazil, they compared 96 postmenopausal breast cancer survivors who were aged more than 45 years with 192 postmenopausal women who did not have breast cancer, to evaluate the risk factors associated with heart problems in postmenopausal breast cancer survivors. The researchers concluded that postmenopausal women who are survivors of breast cancer had a stronger association with risk factors for heart disease and increased abdominal obesity compared to postmenopausal women without a history of breast cancer (Buttros DAB et al, Menopause, 2019).


According to a study published by Dr Carolyn Larsel and team from Mayo Clinic, Rochester, United States, based on 900+ breast cancer or lymphoma patients from Olmsted County, MN,United States, it was found that breast cancer and lymphoma patients were at significantly increased risk of heart failures after the first year of diagnosis which persisted up to 20 years. Additionally, patients treated with Doxorubicin had double the risk of heart failure compared to other treatments (Carolyn Larsen et al, Journal of the American College of Cardiology, March 2018).


These findings establish the fact that some breast cancer therapies can increase the risk of developing heart problems even several years after the treatment (long term chemotherapy side effect). The bottom line is, breast cancer patients need to be counselled on the negative impacts that many of the current treatments can have on their cardiovascular health. Different chemo drugs used for breast cancer can be toxic to the heart and decrease the heart’s pumping ability while radiation and other treatments can lead to scarring of the heart tissue, ultimately leading to serious heart problems. Hence, during and after breast cancer treatments, there is a need to constantly monitor the general health of women who were diagnosed with breast cancer and look out for any signs of heart failures.

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Scientifically Reviewed by: Dr. Cogle

Christopher R. Cogle, M.D. is a tenured professor at the University of Florida, Chief Medical Officer of Florida Medicaid, and Director of the Florida Health Policy Leadership Academy at the Bob Graham Center for Public Service.

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