Breast cancer survival has improved throughout the last decades, but treatment-induced cardiotoxicity remains a major concern. This study aimed to investigate competing causes of death and prognostic factors within a large cohort of breast cancer patients and to describe the heart-specific mortality in relation to the general population.
In this registry-based cohort study, women diagnosed with breast cancer between 2000 and 2011, who were treated with radiotherapy or chemotherapy and followed until 2014, were identified from the Surveillance, Epidemiology, and End Results-18 (SEER-18) database. Cumulative mortality functions were computed. To investigate heart-specific mortality relative to the general population, long-term (≥10 years) standardized mortality ratios (SMRs) were calculated. Prognostic factors for heart-specific mortality were assessed by calculating cause-specific hazard ratios (HRcs) with corresponding 95% confidence intervals using the Cox proportional hazards regression. Subgroup analysis on intermediate-term mortality according to molecular subtypes, for which information was available since 2010, was performed. In total, 347 476 breast cancer patients were eligible to be included in the study. Among all possible competing causes of death, breast cancer accounted for the highest cumulative mortality. Compared with the general population, heart-specific mortality of breast cancer patients treated with radiotherapy or chemotherapy was lower [SMRoverall 0.84 (0.79-0.90)]. In subgroup analysis, human epidermal growth factor receptor 2 (HER2)-positive subtype was not associated with increased heart-specific mortality relative to HER2-negative patients [HRcs 0.96 (0.70-1.32)].
Heart-specific mortality among breast cancer survivors is not increased compared with the general population. Human epidermal growth factor receptor 2-positive patients do not have increased heart-specific mortality compared to HER2-negative patients.
Pharmacology, Toxicology and Pharmaceutical Science
2
3%
Immunology and Microbiology
1
1%
Other
5
6%
Unknown
37
46%
Attention Score in Context
Attention Score in Context
This research output has an Altmetric Attention Score of 192. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 04 December 2019.
All research outputs
#235,260
of 28,815,917 outputs
Outputs from European Heart Journal
#411
of 13,343 outputs
Outputs of similar age
#4,784
of 349,221 outputs
Outputs of similar age from European Heart Journal
#7
of 172 outputs
Altmetric has tracked 28,815,917 research outputs across all sources so far. Compared to these this one has done particularly well and is in the 99th percentile: it's in the top 5% of all research outputs ever tracked by Altmetric.
So far Altmetric has tracked 13,343 research outputs from this source. They typically receive a lot more attention than average, with a mean Attention Score of 33.2. This one has done particularly well, scoring higher than 96% of its peers.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 349,221 tracked outputs that were published within six weeks on either side of this one in any source. This one has done particularly well, scoring higher than 98% of its contemporaries.
We're also able to compare this research output to 172 others from the same source and published within six weeks on either side of this one. This one has done particularly well, scoring higher than 95% of its contemporaries.
