Research highlights the need for cardiologists and cardio-oncologists to be involved in the treatment of men with breast cancer due to common risk factors and potential cardiotoxic effects of treatment.
A small study of male patients with breast cancer found a high prevalence of cardiovascular conditions putting them at risk of heart disease, according to a press release.
Investigators from Georgetown Lombardi Comprehensive Cancer Center and MedStar Washington Hospital Center in Washington, DC, conducted a retrospective chart review of 24 male patients with breast cancer who were evaluated at the medical centers. They were between 38 and 79 years of age and were 42% Black, 29% Caucasian, 4% Hispanic, and 25% identified as another ethnicity. Half of the patients had a family history of breast cancer.
“Due to the rarity of male breast cancer, there is no cardiovascular data from larger clinical trials or population studies,” said Michael Ibrahim, a fourth-year medical student at Georgetown University and one of the study authors, in a press release. “The lack of large data makes it even more important to individualize cardiovascular assessment and management based on each patient’s unique oncologic, therapeutic, and pre-existing cardiovascular risk profile to support them through cancer treatment into survivorship.”
The majority of study participants (79%) had invasive ductal carcinoma, which is the most common type of breast cancer. Invasive ductal carcinoma occurs when the cancer started in the breast ducts and spread into the surrounding breast tissue.
All patients underwent a mastectomy, whereas 4% received anthracycline chemotherapy, 8% received human epidermal growth factor receptor 2 (HER2)-targeted therapy, 16% received radiation, and 71% received hormone therapy. Six patients were diagnosed with a secondary primary malignancy and 3 with a third primary malignancy.
The investigators found that 88% of patients were overweight, 58% had high blood pressure, and 54% had high cholesterol. Tachyarrhythmia preexisted in 8% of patients and developed in 13% while undergoing treatment. Two patients were found to have decreased ejection fraction—or a decrease in how much blood the heart pumps out with each beat—and two patients also developed heart failure following treatment.
“How similar or dissimilar male and female breast cancer patients are is the fundamental, unanswered question,” Ibrahim said. “Contrary to most other medical conditions, data on breast cancer are driven from female patients. We extrapolate the evidence from female breast cancer patients, or the age matched male general population, and apply it to the cardiovascular care for male breast cancer patients. However, in reality, we do not truly know the difference.”
According to the press release, the high prevalence of cardiovascular conditions in male patients with breast cancer requires further investigation to better understand the risk of preexisting heart disease on long term outcomes for this patient population. The findings highlight the need for cardiologists and cardio-oncologists to be involved in the treatment of men with breast cancer due to the common risk factors and potential cardiotoxic effects of breast cancer treatment, according to the study authors.
Male breast cancer patients face high prevalence of heart disease risk factors [news release]. EurekAlert; January 25, 2021. https://www.eurekalert.org/pub_releases/2021-01/acoc-mbc012121.php. Accessed January 25, 2021.