Advancing age may be associated with increased risk of developing venous thromboembolism (VTE) in white and black women with breast cancer, according to recent results from a study published in Thrombosis Research. Additionally, white women with distant metastasis and coexisting medical conditions may have increased risk of developing VTE, while hypertension, heart failure, and hyperlipidemia may be associated with increased risk of developing VTE in black women.
Researchers assessed the risk factors for developing VTE as well as VTE-associated mortality in white and black women with breast cancer by examining data from the SEER-Medicare merged database from 2000 to 2011. Data were collected for 276,028 patients aged 65 years or older who were diagnosed with breast cancer; 251,945 patients were white women and 24,083 patients were black women. The patients were stratified by race. The researchers used logistic regression to analyze risk factors for VTE and Cox proportional hazards regression to evaluate the effect of VTE on mortality.
The risk of VTE was found to increase with each year of age. A total of 6.4% (95% CI, 6.3-6.5) of white women and 10.1% (95% CI, 9.7-10.5) of black women developed VTE (P <.001). In regard to types of VTE, 4.9% (95% CI, 4.8-5.0) of white patients and 7.9% (95% CI, 7.5-8.2; P <.001) of black patients experienced deep vein thrombosis, and 2.8% (95% CI, 2.7-2.9) of white patients and 4.3% (95% CI, 4.1-4.6; P <.001) of black patients experienced pulmonary embolism.
After adjusting for sociodemographic factors, coexisting medical conditions, and tumor characteristics, black women were found to experience a 28% higher risk of developing VTE compared with white women (odds ratio = 1.28; 95% CI, 1.06-1.53).
Tumor size, tumor grade, and receptor status were not independently associated with risk of developing VTE in white or black women. Experiencing a VTE resulted in a higher risk of mortality in white (HR = 1.49, 95% CI, 1.34-1.65) and black (HR = 1.57, 95% CI, 1.23-2.00) women with breast cancer.
Though the risk of VTE is overall lower in patients with breast cancer than in other cancer populations, VTE still affects morbidity, mortality, and health care costs in older women with breast cancer, the authors noted.
1. Faiz AS, Guo S, Kaveney A, Philipp CS. Venous thrombosis and breast cancer in older women: Racial differences in risk factors and mortality [published October 3, 2018]. Thromb Res. doi: 10.1016/j.thromres.2018.10.002