High Prevalence of Cardiovascular Risk Factors Among Male Breast Cancer Patients

January 26, 2021
Patrick Campbell

A study from the ACC's Advancing the Cardiovascular Care of the Oncology Patient meeting suggests male breast cancer patients had an increased presence of cardiovascular risk factors, including development of new tachyarrhythmia.

While most studies of breast cancer patients focus primarily on women, a new study from Georgetown University is offering insight into the increased risk of cardiovascular conditions among male breast cancer patients.

Results of the study, which included data from 24 male breast cancer patients, indicate more than half of these patients had cardiovascular risk factors, including hypertension and hyperlipidemia, while also being at an increased risk due to a prevalence of increased body weight.

"Due to the rarity of male breast cancer, there is no cardiovascular data from larger clinical trials or population studies. 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 pre-existing cardiovascular risk profile to support them through cancer treatment into survivorship," said Michael Ibrahim, MSIV, study investigator and medical student at Georgetown University, in a statement.

With breast cancer more commonly impacting women, investigators noted a lack of evidence examining prevalence of cardiovascular comorbidities in male patients impacted by breast cancer. To do so, investigators designed their study as a retrospective chart review of patient treated at MedStar Washington Hospital Center and the Georgetown Lombardi Comprehensive Cancer Center.

From the chart reviews, investigators obtained data related to baseline characteristics, cancer diagnosis, cancer treatment, CV risk factors, comorbidities, cardiac diagnostic study results, and cardiac events. Additionally, cardiac imaging studies provided information related to changes in ejection fraction.

In total, 24 male breast cancer patients were identified for inclusion in the study. All patients included in the study were 38-79 years old, 42% were African American, 29% were White, 4% were Hispanic, and 25% were categorized as other ethnicity.

The most prominent cancer subtype among this group was invasive ductal carcinoma, which was found in 79% of patients with 21% reported with ductal carcinoma in situ. Additionally, 96% of patients were ER+, 75% were PR+, and 13% were HER2+. Investigators noted 2 patients were BRCA212 mutation-positive and 50% of patients had a family history of breast cancer.

All 24 patients underwent mastectomy. Further analysis of therapies indicated 17% received anthracycline chemotherapy, 8% received HER2-targeted therapy, 16% received radiation therapy, and 71% received hormone therapy. Investigators also pointed out 25% of patients were diagnosed with a second primary malignancy, and 13% were diagnosed with a third primary malignancy.

Upon analysis, investigators found 88% of the study cohort was overweight. Furthermore, 58% and 54%, respectively had hypertension and hyperlipidemia. Investigators identified preexisting tachyarrhythmias in 8% of patients before treatment and pointed out an additional 13% of patients developed a tachyarrhythmia during treatment. Additionally, decreases in ejection fraction were noted among 2 patients and another 2 patients developed heart failure after receiving treatment.

"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,” added Ibrahim.

This study, “Cardiovascular Risk Factors and Comorbidities in Male Breast Cancer patients,” was presented at American College of Cardiology's Advancing the Cardiovascular Care of the Oncology Patient.