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Understanding the connection between heart disease and breast cancer

Female doctor in a white coats holds the hands of a female patient wearing a grey sweater.

The National Cancer Institute reports that the five-year survival rate for breast cancer now tops 90 percent. This is due to advancements in treatments which are enabling breast cancer patients to live longer, healthier lives. Yet, survivors of breast cancer also may be at a greater risk of developing heart disease as a late side-effect of some treatments. Thus, heart health is a key consideration when determining breast cancer therapies.

Accounting for up to 50 percent of all deaths, heart disease remains the leading cause of death in the U.S. for women. This is why it’s so important to understand the benefits and risks of cancer treatment – even months or years after the conclusion of treatment.

Reducing risks of cancer treatment

A study published in the Cleveland Clinic Journal of Medicine found that the risk of several heart conditions increased with left chest radiation. The risk is due to radiation’s ability to kill healthy cells located within the field of radiation being administered to tumors. This is particularly true in patients receiving treatments on the left breast, with the heart sitting under that breast and closer to the radiation beams.   

To minimize radiation exposure of the heart, new radiation techniques have been developed, including deep inspiration breath hold and delivering radiation while patients are lying on their stomach (supine) to minimize the heart being in the radiation field. As well, new techniques (proton radiation) now are used to pinpoint the tumor and where radiation is delivered.

Certain chemotherapies also can increase the risk of heart disease in some breast cancer patients. In some cases, therapies can cause a temporary weakening of the heart muscle. In others, it can lead to long-term heart damage. To minimize this risk, heart protection drugs are often given during chemotherapy.

Protecting the heart before, during and after treatment

With doctors becoming increasingly aware of the link between some breast cancer treatments and heart health, new steps are being taken to reduce the risk—especially in patients who already have other risk factors for heart disease. For some, this means improving heart-health prior to the start of cancer treatment.

At Northwell Health, a collaborative approach to care is taken to ensure cardiac risks are well-managed throughout cancer treatment.

“Northwell Health has an approach that can be defined as multidisciplinary shared care,” according to Sonia Henry, MD, Medical Director, Echocardiography and Attending Cardiologist, Cardio-Oncology, North Shore University Hospital. “Through the collaboration between cardiologists and oncologists, there is a reduced risk during treatment and into survivorship.”

Of note, breast cancer and heart disease share many risk factors, including obesity, lack of physical activity and stress. This is why maintaining healthy lifestyle habits is critical to help reduce the risk of developing both heart disease and breast cancer. This includes:

  • Not smoking
  • Eating a healthy diet
  • Maintaining a healthy weight
  • Increasing physical activity
  • Limiting alcohol
  • Managing stress

The good news is that the number of breast cancer survivors continues to grow. By managing risk factors before, during and after cancer treatment, you can increase your chance of survival after treatment while minimizing any chance of developing heart disease.

Learn more about managing heart disease risk during and after breast cancer treatment. We’re here to answer your questions. Call the Katz Institute for Women’s Health Resource Center at 855-850-5494 to speak to a women’s health specialist.

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