Publication

Long-term cardiovascular effects of breast cancer treatment

Boerman, L., 2020, [Groningen]: University of Groningen. 161 p.

Research output: ThesisThesis fully internal (DIV)Academic

Copy link to clipboard

Documents

  • Title and contents

    Final publisher's version, 87 KB, PDF document

  • Chapter 1

    Final publisher's version, 360 KB, PDF document

  • Chapter 2

    Final publisher's version, 411 KB, PDF document

  • Chapter 3

    Final publisher's version, 531 KB, PDF document

  • Chapter 4

    Final publisher's version, 478 KB, PDF document

    Embargo ends: 12/02/2021

    Request copy

  • Chapter 5

    Final publisher's version, 563 KB, PDF document

    Embargo ends: 12/02/2021

    Request copy

  • Chapter 6

    Final publisher's version, 290 KB, PDF document

  • Chapter 7

    Final publisher's version, 281 KB, PDF document

  • Appendices

    Final publisher's version, 750 KB, PDF document

  • Complete thesis

    Final publisher's version, 2 MB, PDF document

    Embargo ends: 12/02/2021

    Request copy

  • Propositions

    Final publisher's version, 564 KB, PDF document

DOI

Breast cancer (BC) is the most common cancer in women. In western countries, implementation of screening and treatment advances have increased 5-year survival rates up to 82%. Though effective, chemo- and radiotherapy may lead to cardiac dysfunction. The aim of this thesis was to study the prevalence and risk of long-term cardiovascular effects in BC survivors. For that, we evaluated a retrospective cohort and conducted a cross-sectional assessment in BC survivors treated with chemotherapy and/or radiotherapy, at least 5 years after diagnosis. In both studies a comparison was made with age- and general practitioner (GP) matched controls. Longterm BC survivors treated with chemo- and/or radiotherapy were at a two times increased risk of developing mild systolic cardiac dysfunction (LVEF<54%; 15 vs. 7%), and cardiovascular diseases were more prevalent among BC survivors: 31% vs. 24% and 14% vs. 7% in the retrospective and the cross-sectional study, respectively. Bias cannot be excluded. Furthermore, we systematically examined the predictive value of cardiac biomarkers measured at time of BC diagnosis and analyzed biomarker profiles to hypothesize on causal pathways of cardiac dysfunction development among survivors. We did not find a useful predictive biomarker. BC survivors treated with chemotherapy and anti-hormonal therapy appeared to have a higher pro-inflammatory and proarteriosclerotic biomarker profile compared to controls. Based on our findings, we cannot formulate a specific cardiac follow-up for women treated for BC. However, because 15% of these women have a reduced cardiac function, maintaining a healthy lifestyle and having cardiac risk factors treated is important.
Original languageEnglish
QualificationDoctor of Philosophy
Awarding Institution
Supervisors/Advisors
Award date12-Feb-2020
Place of Publication[Groningen]
Publisher
Print ISBNs978-94-034-2230-5
Electronic ISBNs978-94-034-2229-9
Publication statusPublished - 2020

Download statistics

No data available

ID: 116880323