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High risk for cardiovascular disease in postmenopausal breast cancer survivors

Buttros, Daniel de Araujo Brito MD, PhD; Branco, Mauro Terra MD; Orsatti, Claudio Lera PhD; Almeida-Filho, Benedito de Sousa MD; Nahas-Neto, Jorge MD, PhD; Nahas, Eliana A.P. MD, PhD

doi: 10.1097/GME.0000000000001348
Original Study: PDF Only

Objective: Breast cancer patients have a higher mortality risk of cardiovascular disease (CVD) than women from the general population. CVD risk may increase significantly in postmenopausal women with early-stage breast cancer. The aim of this study was to evaluate risk factors for CVD in postmenopausal breast cancer survivors.

Methods: In this cross-sectional study, 96 postmenopausal breast cancer survivors were compared with 192 postmenopausal women. The main group included women with amenorrhea >12 months, aged ≥45 years, with breast cancer, and without established CVD. The control group fulfilled the same criteria, but did not have breast cancer. Groups were matched by age, time since menopause, and body mass index, in a ratio of 1 case to 2 controls (1:2). Women with three or more of the following criteria were diagnosed with metabolic syndrome: waist circumference >88 cm; triglycerides ≥150 mg/dL; high-density lipoprotein cholesterol <50 mg/dL; blood pressure ≥130/85 mm Hg; and glucose ≥100 mg/dL. Immunoassays were used (enzyme-linked immunosorbent assay test) for measurement of plasma heat shock proteins (HSP) 60 and 70 concentrations. Atherosclerotic disease was determined by intima-media thickness (>1 mm) of the carotid arteries and/or the presence of atheromatous plaque assessed by carotid artery ultrasound (scanner duplex).

Results: Breast cancer patients had higher HSP60 levels and lower HSP70 levels than controls (P < 0.05). Analysis showed that the odds of developing metabolic syndrome (odds ratio [OR] = 4.21, 95% CI, 2.28-7.76), atheromatous plaque (OR = 2.61, 95% CI, 1.19-5.72), diabetes (OR = 4.42; 95% CI, 1.86-10.49), hypertriglyceridemia (OR = 2.32, 95% CI, 1.33-4.0), and increased waist circumference (OR = 11.22, 95% CI, 4.0-31.65) was significantly higher in women treated for cancer than in women without breast cancer.

Conclusions: Postmenopausal breast cancer survivors had a stronger association with risk factors for cardiovascular disease than postmenopausal women without breast cancer.

Department of Gynecology and Obstetrics, Botucatu Medical School, Paulista State University (UNESP), Sao Paulo, Brazil.

Address correspondence to: Daniel de Araujo Brito Buttros, MD, PhD, Department of Gynecology and Obstetrics, Botucatu Medical School, Sao Paulo State University (UNESP), Brazil. E-mail:

Received 13 December, 2018

Revised 26 March, 2019

Accepted 26 March, 2019

Funding/support: None.

Financial disclosure/conflicts of interest: None reported.

Disclaimer: The authors have no commercial, proprietary, or financial interest in the products or instruments described in this article.

This abstract was published in a thesis repository of the Paulista State University (UNESP), Botucatu Medical School, São Paulo, Brazil.

© 2019 by The North American Menopause Society.