Risk of breast cancer among patients with bioprosthetic or mechanical valve replacement: a population-based study in Sweden.
Författare
Summary, in English
The association between breast cancer and warfarin is inconclusive as most previous studies examined their association using patients with thromboembolism, whereas thromboembolism itself is a risk factor for cancer. We explored this issue using patients received mechanical heart valves replacement as a proxy for warfarin exposure as these patients need a lifelong warfarin treatment, and compared them with patients received bioprosthesis valves replacement (short-term warfarin treatment) in Sweden between 1987 and 2010. Patients who were operated on for valve replacement were identified from the Swedish Hospital Discharge Registry and linked to the Swedish Cancer Registry to examine the hazard ratios of subsequent breast cancer. A total of 12,242 women were operated on for valve replacement (5481 with mechanical valve and 6401 with bioprosthetic valve). For the entire cohort, the HR of breast cancer was 1.49 (95 % CI 1.09-2.02) among patients with mechanical valve replacement compared to those with bioprosthetic valve replacement. After controlling for a number of confounding factors using propensity score weighting, the HR was 1.69 (95 % CI 1.15-2.47). Our study found that patients with mechanical valve replacement have an increased risk of breast cancer compared to those with bioprosthetic valve replacement. If confirmed, this increased risk should be considered when recommending breast cancer screening for women with mechanical valve replacement. Long-term use of warfarin may explain the observed increase. If so, patients who have used warfarin long-term for other reasons should be studied for a possible increased risk of breast cancer.
Avdelning/ar
- BioCARE: Biomarkers in Cancer Medicine improving Health Care, Education and Innovation
- Allmänmedicin och klinisk epidemiologi
- Allmänmedicin, kardiovaskulär epidemiologi och levnadsvanor
- EpiHealth: Epidemiology for Health
Publiceringsår
2015
Språk
Engelska
Sidor
369-375
Publikation/Tidskrift/Serie
Breast Cancer Research and Treatment
Volym
154
Issue
2
Länkar
Dokumenttyp
Artikel i tidskrift
Förlag
Springer
Ämne
- Public Health, Global Health, Social Medicine and Epidemiology
Status
Published
Forskningsgrupp
- Family Medicine and Clinical Epidemiology
- Family Medicine, Cardiovascular Epidemiology and Lifestyle
ISBN/ISSN/Övrigt
- ISSN: 1573-7217