Long-term health risks in breast cancer survivors

This study examined whether there was a long-term increased risk of secondary health issues in breast cancer survivors.

As screening methods and treatment advances have led to earlier diagnosis and increased survival in breast cancer patients, it has become increasingly important to understand health issues that can occur even years after treatment. Chemotherapy and hormone therapies, such as tamoxifen or aromatase inhibitors, have been associated with an increased risk of lymphedema (swelling in the arms or legs due to blocked lymph nodes), osteoporosis (the loss of bone density and strength that can lead to fractures), and cardiac problems, such as heart attack. 

Understanding the time course of these adverse effects can help with early diagnosis and treatment. These health risks, however, have mostly been examined within 3–5 years following treatment, and few studies have examined the risks in the long-term. The current study surveyed women for 10­–12 years following diagnosis, to determine whether the risks of adverse effects changes with time.

In this study, 2,535 breast cancer survivors and 2,429 women without a history of cancer completed a yearly health survey for 9–12 years. The surveys covered numerous health-related issues, including treatments, cancer risk factors, and adverse events such as lymphedema, decreased bone density, and cardiac problems.

14.1% of breast cancer patients experienced lymphedema compared to 2.5% of those without cancer. Breast cancer patients were 8.6 times more likely to experience lymphedema than women without cancer, particularly patients who had undergone radiation or hormonal therapies. Lymphedema generally occurred within 2 years of diagnosis, but the risk was still elevated up to 10 years later.

11.3% of breast cancer patients experienced osteoporosis compared to 6.9% of those without cancer. Breast cancer patients were 1.5 times more likely to develop low bone density, or osteoporosis, than women without cancer. While many women had developed low bone density by 6 years after diagnosis, the risk remained up to 9 years following. Low bone density was 1.5 times more likely in those who had used hormonal therapies.

4% of breast cancer patients experienced cardiac problems compared to 3.9% of those without cancer. Women with breast cancer did not have an increased risk of cardiac problems compared to women without breast cancer.

This study concluded that conditions such as lymphedema and low bone density are more common in breast cancer survivors than other women. These conditions are more likely after treatments such as radiation and hormonal therapy, and the risks remain many years after diagnosis.

Discuss the risks of long-term health risks related to breast cancer treatment with your physician, as well as surveillance measures.