Format

Send to

Choose Destination
Breast Cancer Res Treat. 2018 Aug;171(1):181-188. doi: 10.1007/s10549-018-4809-8. Epub 2018 May 8.

Incidence and risk factors for congestive heart failure in patients with early breast cancer who received anthracycline and/or trastuzumab: a big data analysis of the Korean Health Insurance Review and Assessment service database.

Author information

1
Division of Oncology, Department of Internal Medicine, Korea University Anam Hospital, Korea University College of Medicine, 73, Inchon-ro, Seongbuk-gu, Seoul, 02841, Republic of Korea.
2
Department of Biostatistics, Korea University Anam Hospital, Korea University College of Medicine, Seoul, Republic of Korea.
3
Department of Pathology, Korea University Anam Hospital, Korea University College of Medicine, Seoul, Republic of Korea.
4
Department of General Surgery, Korea University Anam Hospital, Korea University College of Medicine, Seoul, Republic of Korea.
5
Department of Radiology, Korea University Anam Hospital, Korea University College of Medicine, Seoul, Republic of Korea.
6
Department of Radiation Oncology, Korea University Anam Hospital, Korea University College of Medicine, Seoul, Republic of Korea.
7
Division of Oncology, Department of Internal Medicine, Korea University Anam Hospital, Korea University College of Medicine, 73, Inchon-ro, Seongbuk-gu, Seoul, 02841, Republic of Korea. khpark@korea.ac.kr.

Abstract

PURPOSE:

We aimed to analyze the incidence, time to occurrence, and congestive heart failure (CHF) risk factors for early breast cancer patients treated with anthracycline (AC)-based chemotherapy and/or trastuzumab (T) therapy in Korea.

METHODS:

We included female patients > 19 years old from the Health Insurance Review and Assessment Service database who had no prior CHF history and had been diagnosed with early breast cancer between January 2007 and October 2016.

RESULTS:

We included 83,544 patients in our analysis. In terms of crude incidence for CHF, AC followed by T showed the highest incidence (6.3%). However, 3.1 and 4.2% of the patients had CHF due to AC-based chemotherapy and non-AC followed by T, respectively. The median times to occurrence of CHF were different according to adjuvant treatments, approximately 2 years (701.0 days) in the AC-based chemotherapy group vs 1 year (377.5 days) AC followed by T group. T therapy was associated with earlier development of CHF irrespective of previous chemotherapy, but late risk of CHF 1.2 years after T therapy rapidly decreased in both chemotherapy groups. Multivariate Cox regression analysis revealed that the adjusted hazard ratio for CHF was increased in the group of older patients (≥ 65 years old) who underwent AC followed by T therapy, with Charlson comorbidity index scores of ≥ 2.

CONCLUSIONS:

Our study showed that neo-/adjuvant chemotherapy using T irrespective of previous chemotherapy (AC or non-AC) was associated with significantly increased risk of CHF compared with AC-based chemotherapy in Korean patients with early breast cancer.

KEYWORDS:

Anthracycline; Breast cancer; Congestive heart failure; Trastuzumab

PMID:
29737474
DOI:
10.1007/s10549-018-4809-8
[Indexed for MEDLINE]

Supplemental Content

Full text links

Icon for Springer
Loading ...
Support Center