Women face an increased risk of developing atrial fibrillation in the first 12 months after being diagnosed with breast cancer, researchers report today.
The research, led by Dr Avirup Guha, assistant professor of medicine at Case Western Reserve University, Cleveland, Ohio, also found that patients who developed the condition after a breast cancer diagnosis had a three-fold increased risk of dying from heart or blood vessel problems within one year.
The study, which is published in the European Heart Journal, is the first to evaluate health problems and deaths associated with atrial fibrillation following a diagnosis of breast cancer.
It analysed 85,423 women aged 66 years or older who were diagnosed with breast cancer between 2007 and 2014.
After one year following their diagnosis, 4% had developed atrial fibrillation, double the rate of controls who did not have breast cancer.
The researchers found atrial fibrillation developed in 23.5% of women who did not have surgery as their first course of therapy compared to 10.4% of women who did, and in 66.5% of women who did not receive radiation as their first course of therapy compared to 52.3% of women who did.
Although the highest risk of atrial fibrillation was associated with women who did not have surgery, there was a higher risk when they underwent more complicated surgery such as mastectomy than simple procedures such as lumpectomy.
Patients who received brachytherapy had half the risk of developing atrial fibrillation than women who received external beam radiation.
Dr Guha said: “There has been a significant increase in the number of women who survive breast cancer, but increased heart and blood vessel problems have become limitations of optimal outcomes.
“While atrial fibrillation in people without cancer is associated with an overall poor prognosis, until now little has been known about outcomes from the condition after a breast cancer diagnosis.
“Our study has provided multiple insights. However, the two most stark findings are that atrial fibrillation after breast cancer diagnosis increases deaths from heart and blood vessel problems, and that cancer severity is a strong risk factor for the development of atrial fibrillation.”
When the researchers looked at women who already had atrial fibrillation before being diagnosed with breast cancer, there was no significantly increased risk of dying from any cause within one year of diagnosis.
About 85% of patients were still alive after one year compared to 62% of women who developed atrial fibrillation after a breast cancer diagnosis.
Dr Guha said those with existing atrial fibrillation were not at increased risk of dying after breast cancer diagnosis compared to those who did not develop atrial fibrillation.
Guha A, Fradley MG, Dent SF et al. Incidence, risk factors, and mortality of atrial fibrillation in breast cancer: a SEER-Medicare analysis. European Heart Journal 15 November 2021
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