Abstract WP480: Stroke Risk Among Post-menopausal Breast-cancer Survivors

Abstract

Background and Purpose: Cancer is a well-known risk factor for stroke, yet whether the stroke comorbid with a cancer or the risk further increases along with a long-term survivorship is unclear. Also, whether the stage of cancer and receiving hormonal therapy affect stroke risk particularly in post-menopausal breast cancer survivors (BCS) is yet to be determined. This study aimed to (1) identify comorbid stroke risks at the time of the cancer diagnosis; (2) examine the changes of stroke risk at one, five and ten years after survival; and (3) explore relationships between demographic and cancer-related factors and stroke risks among BCS. Methods: We retrieved 4,152 deidentified BCS data from a Massey Cancer Registry. After excluding 39 pre-existing stroke and selecting who met the Framingham Stroke Risk Score (FSRS) criteria, we included 2141 (mean age of 64.22; SD=7.30 years). Among them, 616 who had all components for the FSRS equation (age, sex, systolic blood pressure, presence of cardiovascular disease, left ventricular hypertrophy, smoking, atrial fibrillation, and presence of diabetes) were included in this analysis. Results: We found that (1) comorbid stroke risk at the time of the diagnosis was 10.6 in terms of the FSRS; among individual risk factors, elevated systolic blood pressure (SBP>140mmHg, 43.3 %) was prominent followed by the presence of cardiovascular disease markers (39.56%) and diabetes (23.11%). (2) The FSRS consistently increased overtime with the largest increase during the first year of survival (10.60 at baseline vs. 16.07, 17.27. and 17.76 at year 1, 5, and 10, respectively). (3) The FSRS was significantly higher in Non-Hispanic Black than Non-Hispanic White (12.55 vs. 9.25, p=0.016 ) across time. Those who received hormonal therapy showed higher FSRS than those who did not (15.88 vs. 8.17, p=0.000 ); tumor stage was not associated with the FSRS. Conclusion: Stroke risk consistently increase along with the survivorship of a breast cancer, particularly among women after their menopause. Prevention and control of high blood pressure and diabetes should be a target of intervention to reduce the stroke risk among post-menopausal breast cancer survivors.