Background:
Breast cancer (BC) patients are at increased risk of cardiovascular disease (CVD), largely due to cardiotoxic cancer treatments[1, 2] and pre-existing risk factors, such as hypertension, diabetes, tobacco smoking and low physical activity.[3, 4] Several measures/tools have been suggested or used in research to determine baseline risk and appropriate CVD care during and beyond cancer treatment. This review aims to scope the literature to identify baseline (pre-treatment) CVD risk assessment tools/measures for BC patients proposed, developed, validated, or used in research.
Methods:
PubMed, Embase and Google Scholar were searched for articles published January 2013 – March 2024, using relevant terms. Eligibility was assessed and key data extracted from included articles independently by two reviewers. Publications included research articles (observational and experimental studies), position/policy, commentary and review papers that addressed the scoping review aim.
Results: 142 articles were included; 56% research articles. Thirteen tools assessed risk of CVD broadly (n=3), specifically cardiotoxicity or heart failure (n=8), venous thromboembolism (n=1) or CVD death (n=1) in people with BC. Four tools went through validation and performed poor to moderate in stratifying BC patients into correct risk categories. All tools included age as a risk factor; other common risk factors were type of BC treatment and pre-existing hypertension and CVD. While clinical guidance and recommendations were identified, these were either for cancer patients broadly or for specific treatment types, rather than specifically for people diagnosed with BC.
Conclusion: This scoping review identified a number of existing tools/measures with common risk factors but which performed poorly in correctly stratifying BC patients into risk categories. Further work is needed to optimise the effectiveness of baseline CVD risk assessments for monitoring BC patients during and beyond treatment to improve CVD health and outcomes.