Dr. Noel Peterson, MD FACC
252-757-3333 or 252-758-3000
Eastern Cardiology PA | 2090 W. Arlington Blvd. | Greenville NC | 27834
Dr. Noel Peterson, MD FACC | Eastern Cardiology PA
October is breast cancer awareness month. While all women are aware of their risk for breast cancer, many of us are not aware of the coexistence of common risk factors associated with both heart disease and breast cancer. In addition, cancer therapy can potentially have cardiotoxic effects both at time of treatment, as well as years after treatment. The risk of mortality from heart disease is higher in breast cancer survivors than in women without a history of breast cancer. This risk usually presents approximately 7 years after diagnosis of breast cancer. Recognition and early treatment of risk factors can help to decrease the burden of heart disease in breast cancer survivors
Heart disease affects approximately 47.8 million women and breast cancer affects approximately 3.32 million women. Breast cancer and heart disease share several common risk factors. These shared risk factors include age, diet, family history, alcohol intake, hormone replacement, overweight/obesity, physical inactivity, and tobacco use. Roughly 80% of heart disease can be prevented by modifying risk factors such as following a healthy diet, physical activity, and a healthy weight; abstinence from tobacco; blood pressure control; diabetes management; and a good cholesterol profile. Aggressive management of heart disease risk factors can reduce the lifetime risk of developing cancer and through risk factor modification, some cases of breast cancer might be prevented.
Common Risk Factors
Dietary Patterns: The Western dietary pattern (red or processed meats, refined grains, sweets and high-fat dairy products) is associated with a higher breast cancer risk as compared with a healthy diet (high in fruits and vegetables, poultry, fish, low-fat dairy products and whole grains), especially in premenopausal women. The relationship between the frequency of consumption of fast foods, energy dense foods, and sugary drinks has been examined in both black and white females and did reveal a positive association between the frequency of consumption of these foods types and increased risk for breast cancer.
Physical Activity: Current guidelines recommend a minimum of 150 min of moderate-intensity physical activity per week. Only 17.6% of women meet these guidelines. There is an elevated risk of both heart disease and breast cancer in women who have low physical activity (less than 150 min/week of moderate intensity physical activity). In addition, sedentary behavior, which is defined as activities performed in the sitting or reclining position has been associated with increased risk for both heart disease and breast cancer. Sitting for > 10 hours per day (includes driving, watching TV, working at desk/computer) compared with <5 hours per day is associated with increased risk. Reducing sedentary behavior and increasing physical activity are targets for both breast cancer and heart disease prevention interventions.
Overweight, Obesity, and BMI: Overweight and obesity (BMI >25 and >30, respectively) are major risk factors for heart disease. Severe obesity (BMI >40) poses an even greater risk of heart disease. Obesity is also a factor associated with breast cancer risk especially in postmenopausal women. In postmenopausal women each 5kg (11 pounds) increase in weight gain was associated with 11% increase risk of breast cancer.
Tobacco Use: Cigarette smoking is a major risk factor for heart disease, with increased risk of heart disease by 25%. There is an increased risk for certain types of breast cancer with smoking, however the relationship is dependent on certain genetic variants of breast cancer.
Postmenopausal Hormone Replacement Therapy (HRT): Several studies have shown an association between postmenopausal hormone use and the risk of breast cancer as well as heart disease. This relationship is complex and depends on the type of HRT, the duration of therapy, intact uterus versus hysterectomy, history of heart disease; and is beyond the scope of this article. Not all HRT is bad, however it requires a personalized discussion with your gynecologist.
Age and Genetics: Both are risk factors that you can not modify. Early menarche increases both risk of heart disease and breast cancer, whereas early menopause increases your risk for heart disease but decreases your risk for breast cancer.
Cancer treatment (radiation, chemotherapy and targeted therapies) can potentially cause adverse cardiovascular effects which can present during treatment or may have a delayed presentation up to years later. Some of cardiac complications include: heart failure, high blood pressure, arrhythmias, atherosclerosis of cardiac and carotid arteries, valvular disease, blood clots, pulmonary hypertension and pericarditis (inflammation of lining of heart). By no means am I suggesting that you do not undergo treatment for breast cancer due to fear of heart disease. I personally believe that you should follow the recommendations of your oncologist as they have spent many years studying treatment of breast cancer and they are up to date with the latest clinical trials and research regarding the different therapies – they are the experts! However, I do want you to know that there are potential cardiac risks that may require diagnostic test before the initiation of therapy and even after you are cured of your breast cancer you need to be monitored closely for prevention and treatment of heart disease. If you have had radiation therapy, chemotherapy, endocrine therapy or targeted therapies you need to be evaluated by a cardiologist to determine the potential cardiotoxicity of your cancer treatment and to determine and prevention and treatment plan for heart disease.
Please call to make an appointment. You can reach Dr. Noel Peterson at 252-757-3333 or 252-758-3000. Office information and business hours are listed below
Eastern Cardiology, PA
Park Place Professional Center
2090 W Arlington Blvd., Suite B
Greenville, NC 27834
(Entrance on Hemby)
Our office is open Monday through Friday, from 8:30am to 5pm.
•We know your time is valuable, but sometimes emergencies can cause delays. If we know your appointment will be affected, we will try to notify you.
•If for any reason you can not keep your appointment, please give us 24 hours notice.
•Be certain to bring any medications you are currently taking. This will allow us to accurately record your drugs and dosage.
•Insurance coverage needs to be noted, so please bring any insurance, Medicare or identification cards. Our staff will be happy to answer any questions you may have prior to your doctor visit.