New Study Links Heart Disease And Breast Cancer

Cardiovascular disease and cancer are the two leading causes of death in the U.S. Yet most people don’t consider the possibility of facing both at the same time.

A new research study is a reminder that this “double diagnosis” does happen. Even more concerning, the study suggests that women with cardiovascular disease are more likely to be diagnosed with breast cancer at a later stage.

We asked Ajita Narayan, MD, a cancer specialist at Franciscan Health, to explain the findings and what they may mean for women. The good news: routine breast cancer screenings remain the best way to detect cancer early — when it’s most treatable — regardless of heart health.

The study, Cardiovascular Disease and Breast Cancer Stage at Diagnosis, appeared in the Journal of the American Medical Association (JAMA) Open Network earlier this year.

Thank you for talking with us today about this study, Dr. Narayan. For those who aren’t familiar with the research, can you describe the findings?

Dr. Narayan: The research concluded that patients with advanced breast cancer at the time of diagnosis were more likely to have or suffer from some type of cardiovascular disease.

This study isn’t the first to suggest a link. Previous research, for example, showed that in mice with cardiovascular disease, specific proteins in the body promote fast-growing tumors.

Taken together, these studies suggest that people who have cardiovascular disease are at higher risk of getting cancer. And, if they do get cancer, it’s likely to be at a more advanced stage.

The JAMA study focused on breast cancer. But the same phenomenon seems to happen in other cancers, such as colon and prostate cancer.

Why would having cardiovascular disease increase the chances of advanced breast cancer diagnosis?

Dr. Narayan: The preclinical study I mentioned gives one possible explanation: specific proteins promote aggressive tumor growth in people with cardiovascular disease. Researchers continue to study this theory.

Another possibility is that women with cardiovascular disease are diagnosed with breast cancer later in the disease process than other women. They could prioritize their cardiovascular health and pay less attention to other health risks. For example, they may delay their mammograms.

All of these factors may help explain why women with cardiovascular disease are at increased risk for advanced breast cancer.

Should women with cardiovascular disease be extra-vigilant about detecting breast cancer early?

Dr. Narayan: It’s unclear whether women with cardiovascular disease should follow a different early-detection plan than women who don’t. We still have a lot of unanswered questions. For example, we don’t know if certain types of cardiovascular disease increase your risk — is it heart attack alone, stroke or all cardiovascular disease?

While researchers continue to search for answers, my advice is that all women should be vigilant about detecting breast cancer early. And one of the best ways to do that is to have routine mammograms.

Screening mammogram guidelines

The American Cancer Society (ACS) recommends these guidelines for screening mammograms for women at average risk for breast cancer:

• Begin yearly mammograms between the ages of 40 and 45.
• Continue annual mammograms from ages 45 to 54.
• Switch to having a mammogram every other year starting at age 55, if desired.

Women should continue to get screening mammograms as long as they are in good health and expected to live 10 more years or longer.

Your doctor may recommend a different screening schedule if you are at higher risk of developing breast cancer or if you have symptoms.

What can women do to prevent breast cancer?

Dr. Narayan: Your risk for breast cancer is due to a combination of factors. The main ones are being a woman and getting older. Those are factors you can’t change. But you can lower your risk for breast cancer with these healthy lifestyle habits:

• Achieve and maintain a healthy weight
• Be physically active
• Manage your stress
• Don’t smoke
• Limit your alcohol intake

These are the same healthy habits that can help prevent cardiovascular diseases such as heart attack, high cholesterol and stroke.

Learn more about how healthy habits can reduce your cancer risk.

This advice is easy to understand but challenging to follow. Can you suggest one high-impact change to help people get started?

Dr. Narayan: Get moving! Physical activity benefits our bodies in so many ways. It reduces the risk of chronic diseases such as cardiovascular disease, diabetes and certain cancers, including breast, prostate and colon cancers. Regular exercise also helps you feel better, function better and sleep better.

For substantial health benefits, the goal is to get at least 150 minutes a week of moderate aerobic activity or 75 minutes a week of vigorous aerobic activity (or a combination of both).

You can start small. For example, let’s say you only have 15 minutes to spare today. You can spend five minutes going up and down the stairs, another five minutes walking in your neighborhood and another five doing squats in your living room.

Get your heart rate up and keep track of your progress. It may not seem like a lot, but small choices can make a big difference in your health and overall well-being.