Evidence map›Paper›PMID 38458842›Full record

ArticleClinical breast cancer2024

Impact of Anti-Estrogen Therapy on Early Cardiovascular Referrals, Tests and Medications in Premenopausal Women with Operable Breast Cancer.

Emily Douglas, Beverly Levine, Ahmer Ansari, Katherine Ansley, Susan Melin, Carolyn J Park, Karl Richardson, Sarah Hatcher, Ralph B D'Agostino, Jennifer H Jordan and 1 more

Open access · greenAbstract read
In one paragraph

Article in Clinical breast cancer, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
2.0field-weighted citation impact, top 13% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed, 5 citations in OpenAlex.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors at 4 institutions in 2 countries.

Emily DouglasSection on Hematology and Oncology, Department of Internal Medicine, Wake Forest University School of Medicine, Winston-Salem, NC, USA.
Beverly LevineDepartment of Social Sciences and Health Policy, Wake Forest University School of Medicine, Winston-Salem, NC, USA.
Ahmer AnsariSection on Hematology and Oncology, Department of Internal Medicine, Wake Forest University School of Medicine, Winston-Salem, NC, USA.
Katherine AnsleySection on Hematology and Oncology, Department of Internal Medicine, Wake Forest University School of Medicine, Winston-Salem, NC, USA.
Susan MelinSection on Hematology and Oncology, Department of Internal Medicine, Wake Forest University School of Medicine, Winston-Salem, NC, USA.
Carolyn J ParkSection on Cardiovascular Medicine, Department of Internal Medicine, Wake Forest University School of Medicine, Winston-Salem, NC, USA.
Karl RichardsonSection on Cardiovascular Medicine, Department of Internal Medicine, Wake Forest University School of Medicine, Winston-Salem, NC, USA.
Sarah HatcherDivision of Medical Oncology, Department of Internal Medicine, Duke University, Durham, NC, USA; Duke Cancer Institute, Duke University, Durham, NC, USA.
Ralph B D'AgostinoDepartment of Social Sciences and Health Policy, Wake Forest University School of Medicine, Winston-Salem, NC, USA.
Jennifer H JordanDepartment of Biomedical Engineering, Virginia Commonwealth University, Richmond, VA, USA; Pauley Heart Center, Virginia Commonwealth University, Richmond, VA, USA.
Alexandra ThomasDivision of Medical Oncology, Department of Internal Medicine, Duke University, Durham, NC, USA; Duke Cancer Institute, Duke University, Durham, NC, USA. Electronic address: alexandra.thomas@duke.edu.
Wake Forest University · USCancer Institute (WIA) · INDuke University · USVirginia Commonwealth University · US

Funding

Cardiovascular Impact of Near-complete Estrogen Deprivation for Breast CancerR01HL159393 · NHLBI · WAKE FOREST UNIVERSITY HEALTH SCIENCES · PI Jennifer Hawthorne Jordan, Alexandra Thomas · 2022 to 2026
$3.0M
NHLBI NIH HHS R01 HL159393
6 · The paper itself

Abstract

introductionPremenopausal women with high-risk hormone receptor (HR)-positive breast cancer often receive ovarian function suppression (OFS) and anti-estrogen therapy which induces near complete estrogen deprivation (NCED). This treatment improves recurrence-free survival but may increase cardiovascular risk. We sought to identify patterns of cardiovascular care and outcomes in premenopausal women with operable breast cancer.

methodsPremenopausal women ≤ 50 years of age with stage I-III HR-positive or triple negative breast cancer (TNBC) were identified by retrospective review. We categorized women into 3 groups based on anti-estrogen therapy approach: NCED (HR + OFS), anti-estrogen therapy without OFS (HRnoOFS), and no anti-estrogen therapy (TNBC). Baseline characteristics, post-diagnosis cardiovascular events and cardiovascular actions (tests, referrals and medications) were recorded. Categorical variables were compared among the groups using chi-square and Fisher's exact tests; continuous outcomes were compared using ANOVA.

results82, 83, and 52 women were identified in the HR + OFS, HRnoOFS, and TNBC groups respectively; mean follow-up was 5.0 years. Mean number of cardiovascular actions per year were highest in the HR + OFS group compared with HRnoOFS and TNBC groups (0.35 vs. 0.20 and 0.27, respectively; P = .036). The HR + OFS group had significantly more referrals and tests per year than the other groups. Cardiovascular medication initiation did not differ among groups.

conclusionsIn this early follow-up period, there were meaningful numbers of cardiovascular actions, with women on NCED experiencing the most per year. Future work should seek to further understand the impact of anti-estrogen therapy on the cardiovascular health of premenopausal women and test strategies to mitigate cardiotoxicity.

Indexed as

Breast NeoplasmsCardiovascular DiseasesPremenopauseReferral and ConsultationAdultEstrogen AntagonistsFemaleFollow-Up StudiesHumansMiddle AgedReceptors, EstrogenRetrospective StudiesTriple Negative Breast NeoplasmsEstrogen AntagonistsReceptors, EstrogenBreast neoplasmsCardiovascular medicationsCardiovascular referralsCardiovascular testsEstrogen-deprivation

Identifiers

PMID38458842
PMCPMC11162933
OpenAlexW4391887177

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.