Early cardiology referral in breast cancer patients.

Abstract

e24004 Background: Breast cancer treatment may have a negative impact on cardiovascular health. Treatment for various subtypes of breast cancer involve using cardiotoxic medications. Hormone-positive breast cancer makes up ~75% of all breast cancers and treatment involves depleting women of systemic estrogen which can increase one’s risk for cardiovascular disease. Our institution began an initiative to refer all women with breast cancer who receive anti-estrogen therapy or any known cardiotoxic medications to the Mount Sinai Women’s Heart and Vascular Center (WHC). The WHC conducted comprehensive evaluation including cardiac imaging and symptom surveillance for these patients at risk for cardiac disease as well as closer monitoring of those with known cardiac illness. This study presents the characteristics of breast cancer patients who pursued care at the WHC. Methods: Breast cancer patients at the Mount Sinai Dubin Breast Center receiving anti-estrogen therapy, anti-HER2 blocking agents or anthracycline were given a flyer with information about the WHC and encouraged to initiate care. We performed a retrospective chart review to collect the clinicodemographic data of all breast cancer patients who initiated care at the WHC. Statistical analysis was done with descriptive statistics and a one-sample test using a multilevel regression analysis of multiple studies reporting on comorbidity prevalence of breast cancer patients from 1990 to 2020 for comparison. Results: We identified 42 patients from the Mount Sinai Dubin Breast Center who initiated care at the WHC. Median age of the patients was 61.55 years, and median BMI was 25.62. 59.5% of our patients identified their race as white, 11.9% identified as Asian, 9.5% identified as black and 11.9% identified as other. 16.7% identified as Hispanic or Latino ethnicity. The Table illustrates the prevalence of various comorbidities of the patients. When compared to historical data of comorbidities of breast cancer patients from 1990 to 2020, our group had higher rates of hypertension (Table). Conclusions: Our study emphasizes the role of preventive cardiology in breast cancer patients at risk for cardiovascular disease. Our data shows that early referral to cardiology is currently more prevalent among patients with higher rates of hypertension but not other cardiac comorbidities, type II diabetes, chronic kidney disease, or cerebrovascular disease. Future studies will involve collecting outcome data of patients who initiate early cardiac care. Prevalence of comorbidities of breast cancer patients. Disease Prevalence (%) in study [95 % CI] Prevalence (%) in breast cancer population Hypertension 59.5 [44.7-74.3] 31.57 Diabetes 16.7 [5.4-28.0] 11.52 Heart Failure 7.1 [0.0-14.9] 5.08 Chronic Kidney Disease 4.8 [0.0-11.3] 2.20 Cerebrovascular Disease 2.4 [0.0-7.0] 3.95 Coronary Artery Disease 4.8 [0.0-11.3] 1.37