Women gaining weight after a diagnosis of breast cancer, a relatively common phenomenon, are at greater risk of heart failure, according to a new study published in the Jama Oncology. Cardiac dysfunction post-treatment of breast cancer is a subject of concern while certain therapies, notably anthracyclines (which include doxorubicin and epirubicin) and trastuzumab (used in HER2+ cancers, i.e. 12 to 20% tumors according to the Inca), have cardiotoxic effects.
South Korean researchers observed the occurrence of heart failure in the 44,000 women included. In the study, patients were separated into five groups: weight maintained (64%), loss of more than 10% (6%), loss of 5 to 10% (15.7%), weight gain of 5 at 10% (10.7%) and weight gain greater than 10% (3.5%). Among women with obesity before cancer diagnosis, two-thirds maintained their obesity.
A risk that increases with weight gain
Over an average five-year follow-up period, weight gain of 5% to 10% was associated with a 59% increase in heart failure risk independent of cancer treatment and other risk factors (hazard adjusted aHR ratio = 1.59). In women with weight gain greater than 10%, the risk is increased by 85%. So, the more the weight increases, the higher the risk of heart failure.
The researchers did not identify a link between weight loss and the risk of heart failure and did not observe an increase in risk in patients with no weight change, even in cases of obesity present before diagnosis.
The study highlights the importance of carrying out therapeutic interventions around weight in these patients, “particularly during the first years after diagnosis, to preserve cardiovascular health”. The authors emphasize the need to carry out studies to identify the most relevant ones (for example medicinal with GLP-1 analogues). They also call for caution when interpreting their results, which are not necessarily generalizable to other ethnic groups.
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