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@ARTICLE{Weberpals:142590,
      author       = {J. Weberpals$^*$ and L. Jansen$^*$ and O. J. Müller and H.
                      Brenner$^*$},
      title        = {{L}ong-term heart-specific mortality among 347 476 breast
                      cancer patients treated with radiotherapy or chemotherapy: a
                      registry-based cohort study.},
      journal      = {European heart journal},
      volume       = {39},
      number       = {43},
      issn         = {1522-9645},
      address      = {Oxford},
      publisher    = {Oxford University Press},
      reportid     = {DKFZ-2019-00308},
      pages        = {3896 - 3903},
      year         = {2018},
      abstract     = {Breast cancer survival has improved throughout the last
                      decades, but treatment-induced cardiotoxicity remains a
                      major concern. This study aimed to investigate competing
                      causes of death and prognostic factors within a large cohort
                      of breast cancer patients and to describe the heart-specific
                      mortality in relation to the general population.In this
                      registry-based cohort study, women diagnosed with breast
                      cancer between 2000 and 2011, who were treated with
                      radiotherapy or chemotherapy and followed until 2014, were
                      identified from the Surveillance, Epidemiology, and End
                      Results-18 (SEER-18) database. Cumulative mortality
                      functions were computed. To investigate heart-specific
                      mortality relative to the general population, long-term
                      (≥10 years) standardized mortality ratios (SMRs) were
                      calculated. Prognostic factors for heart-specific mortality
                      were assessed by calculating cause-specific hazard ratios
                      (HRcs) with corresponding $95\%$ confidence intervals using
                      the Cox proportional hazards regression. Subgroup analysis
                      on intermediate-term mortality according to molecular
                      subtypes, for which information was available since 2010,
                      was performed. In total, 347 476 breast cancer patients
                      were eligible to be included in the study. Among all
                      possible competing causes of death, breast cancer accounted
                      for the highest cumulative mortality. Compared with the
                      general population, heart-specific mortality of breast
                      cancer patients treated with radiotherapy or chemotherapy
                      was lower [SMRoverall 0.84 (0.79-0.90)]. In subgroup
                      analysis, human epidermal growth factor receptor 2
                      (HER2)-positive subtype was not associated with increased
                      heart-specific mortality relative to HER2-negative patients
                      [HRcs 0.96 (0.70-1.32)].Heart-specific mortality among
                      breast cancer survivors is not increased compared with the
                      general population. Human epidermal growth factor receptor
                      2-positive patients do not have increased heart-specific
                      mortality compared to HER2-negative patients.},
      cin          = {C070 / G110 / L101},
      ddc          = {610},
      cid          = {I:(DE-He78)C070-20160331 / I:(DE-He78)G110-20160331 /
                      I:(DE-He78)L101-20160331},
      pnm          = {323 - Metabolic Dysfunction as Risk Factor (POF3-323)},
      pid          = {G:(DE-HGF)POF3-323},
      typ          = {PUB:(DE-HGF)16},
      pubmed       = {pmid:29635274},
      doi          = {10.1093/eurheartj/ehy167},
      url          = {https://inrepo02.dkfz.de/record/142590},
}