Purpose: Breast cancer patients may have poor outcomes due to the toxic effects of breast cancer treatments in the presence of co-morbid conditions. Thus, it is hypothesized that racial disparities in breast cancer outcomes are, in part, related to a higher prevalence of certain co-morbid conditions prior to treatment among black compared to white women. As a first step to addressing this hypothesis, this analysis examined racial differences in cardiovascular health and co-morbid conditions among breast cancer survivors initiating aromatase inhibitor (AI) therapy.

Methods: Baseline data were analyzed from 49 white and 29 black women participating in an ongoing cohort study of the cardiovascular health of breast cancer patients over the first year of AI therapy. Prior to initiating AI therapy, women enrolling in the study completed a questionnaire and had a cardiovascular health evaluation that included a carotid intimal medial thickness (cIMT) ultrasound. Cardiovascular disease risk percentile was assigned using the cIMT data; category assignment was based on published age- and race-specific percentile risk categories from the Atherosclerosis Risk in Communities (ARIC) study.

Results: The white breast cancer patients were slightly older than their black counterparts (mean 62.5 years versus 61.5 years; p=0.6) and less likely to have had chemotherapy (32.6% versus 42.3%; p=0.4). After adjusting for age, the black breast cancer patients were more likely than their white counterparts to report having been diagnosed with hypertension (odds ratio (OR) 6.7; 95% confidence interval (CI) 2.0, 22.9) and diabetes (OR 2.5; 95% CI 0.6, 10.2). However, mean cIMT (mean 0.65 mm versus 0.64; p = 0.6) and the distribution of patients in the cardiovascular disease risk percentile categories did not differ significantly by race (p=0.6).

Conclusions: Black breast cancer survivors have a higher prevalence of cardiovascular co-morbid conditions compared to their white counterparts. The presence of these cardiovascular co-morbidities at diagnosis may affect treatment choices if continued follow-up demonstrates an adverse impact of estrogen deprivation therapy on cardiovascular outcomes. Enrollment into this study is currently ongoing. This research was supported by a Susan G. Komen for the Cure Health Disparities Career Catalyst grant.

Citation Format: Lisa Gallicchio, Carla Calhoun, Kathy J. Helzlsouer. Cardiovascular health among black and white breast cancer patients initiating aromatase inhibitor therapy. [abstract]. In: Proceedings of the Sixth AACR Conference: The Science of Cancer Health Disparities; Dec 6–9, 2013; Atlanta, GA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2014;23(11 Suppl):Abstract nr C33. doi:10.1158/1538-7755.DISP13-C33

©2014 American Association for Cancer Research.
2014