Feb. 15, 2008 Breast cancer survivors, particularly older women, are at greater risk of death from non-cancer causes than from breast cancer.
As breast cancer treatments improve, patients are surviving longer, and many are dying of causes unrelated to breast cancer. Judith-Anne Chapman, Ph.D., and colleagues with the National Cancer Institute of Canada Clinical Trials Group investigated whether certain factors, such as pre-existing diseases, are associated with the risk of death from breast cancer, other cancers, or causes other than cancer. For about four years, the researchers followed over 5,000 women enrolled in a breast cancer trial.
During the follow-up, 256 participants died. Non-breast cancer deaths were more common than deaths from breast cancer, and older women, in particular, were more likely to die of other causes. While 60 percent of women in the trial died of causes not related to breast cancer, this figure jumped to 72 percent among women 70 years and older. Two factors were associated with cause of death. Women with pre-existing heart disease were more likely to die of non-cancer causes, and women with pre-existing osteoporosis were at greater risk of dying from cancers other than breast cancer. Women were more likely to die from breast cancer if cancer cells had spread to the lymph nodes.
"Routine use of screening mammography and improved therapeutic management of breast cancer...will mean that more women will survive breast cancer to older ages, at which they might have a higher risk of death from causes other than breast cancer," the authors write.
In an accompanying editorial, Sharon Giordano, M.D., and Gabriel Hortobagyi, M.D., of the University of Texas M. D. Anderson Cancer Center in Houston discuss the need for oncologists to consider a patient's pre-existing health problems when determining treatment options.
For example, "cardiovascular disease is of particular concern to breast cancer patients because of its prevalence and the reality that many therapies for breast cancer can cause cardiac dysfunction," the editorialists write.
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