Reasons for and time to seeking healthcare in cardiac clinics by women with a history of successfully treated breast cancer

Abstract

Background: Various methods of breast cancer treatment are potentially cardiotoxic: anthracycline chemotherapy, HER2-targeted therapy, and radiation therapy to the left side of the chest. In clinical practice, cardiologists deal with a wide range of complications caused by the mentioned methods.Objective: To analyze the reasons for and timing of seeking healthcare in cardiac clinics by women with a history of successfully treated breast cancer.Methods: Our single-center retrospective observational study included 125 women (mean age at the time of seeking healthcare was 68.1 ± 8.6 years).Results: Patients with a history of radiation therapy had higher peak velocity (P = .015) and peak gradient (P = .017) across the aortic valve. As part of their examination and treatment 71 patients underwent coronary angiography. Of them, 21 patients (29.6%) had coronary artery stenting, and 23 patients (32.4%) underwent coronary artery bypass grafting. Forty-two patients (33.6%) underwent heart valve replacement: aortic valve replacement in 92.9% of the cases (n = 39) and mitral valve replacement in 7.1% of the cases (n = 3). We found a strong negative correlation between the age at the time of radiation therapy and the time to onset of valvular heart disease (r = −0.748; P = .000004) and an average negative correlation between the age and the time to surgical treatment (r = −0.695; P = .00003).Conclusion: We studied the main reasons for seeking healthcare in cardiac clinics by women with a history of breast cancer, analyzed cardiac operations in terms of antitumor therapy types, and found a strong correlation between the age at the time of antitumor therapy and the time to onset of valvular heart disease, as well as the time to cardiac surgery. Received 20 November 2022. Revised 21 May 2023. Accepted 31 May 2023. Funding: The study was supported by Ministry of Science and Higher Education of Russian Federation (No. 075-15-2022-301). Conflict of interest: The authors declare no conflict of interest. Contribution of the authors: The authors contributed equally to this article.