Recent research has uncovered an unsettling connection between heart disease and more advanced breast cancer at the time of diagnosis. The study suggests that women with preexisting heart disease may face a heightened risk of developing advanced forms of breast cancer, which could significantly impact their treatment options and survival chances. This new insight may also prompt a reevaluation of screening practices for breast cancer patients, particularly those with cardiovascular conditions.
Increased risk of advanced tumors in heart disease patients
A large-scale study involving over 20,000 breast cancer patients aged 66 and older has revealed a concerning pattern: women with a history of heart disease are more likely to be diagnosed with advanced breast cancer, rather than earlier, localized forms of the disease. Of these patients, approximately half had cardiovascular disease. The findings, published in JAMA Network Open, show that those with advanced breast cancer were 10 percent more likely to have cardiovascular disease than those diagnosed with earlier-stage tumors.
“There is growing evidence that cardiovascular disease, in particular cardiovascular events like a heart attack, leads to a suppressed immune system,” said Dr. Kevin Nead, senior study author and assistant professor of epidemiology and radiation oncology at the University of Texas MD Anderson Cancer Center. “When the immune system is suppressed, it may be less effective at doing its job to prevent the development, growth, and spread of cancer.”
The most common breast cancer type shows the strongest link
The study found that the connection between heart disease and breast cancer was most prominent among patients with hormone receptor–positive (HR+) breast cancer, the most common type of breast cancer, which is fueled by hormones like estrogen and progesterone. In particular, women with advanced HR+ breast cancer were 11 percent more likely to have cardiovascular disease compared to those with early-stage HR+ breast cancer.
In addition to HR+ breast cancer, the study also examined cases of locally advanced and metastatic breast cancer. Women with locally advanced tumors, where cancer has spread to nearby tissues and lymph nodes but not to distant organs, had a 9 percent higher likelihood of having heart disease. In contrast, women with metastatic breast cancer—where the disease has spread to distant organs—were 20 percent more likely to have cardiovascular disease.
Are heart disease and breast cancer linked by common factors?
While the study offers compelling evidence of a relationship between cardiovascular disease and advanced breast cancer, it does not prove that heart disease directly causes or accelerates the progression of cancer. Experts suggest that both conditions may share common underlying factors, such as immune system suppression or inflammation, which could help explain this connection.
“Or inflammation from the cancer might cause heart damage, such as the development of plaques in the coronary arteries,” said Dr. Alexandra Thomas, an oncologist at the Duke Cancer Institute, who was not involved in the study. This interplay between cancer and heart disease could potentially create a vicious cycle, where each condition exacerbates the other.
It is also worth noting that the study participants were predominantly white, which limits the ability to draw conclusions about other racial or ethnic groups. Additionally, the study focused solely on patients aged 66 and older, leaving out a younger demographic that could have different outcomes.
The role of heart-healthy habits in cancer prevention
The results of this study add to the growing body of evidence that maintaining a heart-healthy lifestyle could play a significant role in preventing not only heart disease but also cancer. Dr. Nead, who led the study, emphasized the importance of cardiovascular health in reducing cancer risk. “A heart-healthy lifestyle can help prevent breast cancer and contribute to less-advanced disease at diagnosis, which ultimately may have a greater chance of cure,” he said.
Regular physical activity, a balanced diet, stress management, and avoiding smoking are among the lifestyle changes that can benefit both heart health and cancer prevention. Dr. Daniel Addison, a cardiologist and director of the cardio-oncology program at Ohio State University, further highlighted the connection between heart disease management and cancer outcomes. He noted, “Controlling heart disease is another opportunity to lower cancer risk. Periodic screening for heart disease, especially after intense cancer treatment, may also help prevent or control heart disease in cancer patients.”
Reconsidering screening practices
Given the increased risk of advanced breast cancer in women with heart disease, experts suggest that early and frequent screening may be beneficial for this group. Regular mammograms, ideally starting at an earlier age, could improve early detection, ultimately leading to better treatment outcomes.
“Women with cardiovascular disease could benefit from initiating breast cancer screening earlier or undergoing more frequent mammograms,” Dr. Nead said. This could lead to earlier interventions and, potentially, better survival rates for women facing both heart disease and breast cancer.
A holistic approach to women’s health
The study sheds light on the complex relationship between heart disease and breast cancer, urging healthcare providers to adopt a more holistic approach to women’s health. By understanding how cardiovascular health impacts breast cancer outcomes, physicians can better tailor their screening recommendations and treatment plans, improving the chances of early detection and better outcomes for these patients.