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Cited by 31Cancer survivorship and careChildhood Cancer Survivors' Quality of LifeCancer-related cognitive impairment studies

Accelerated aging in breast cancer survivors and its association with mortality and cancer recurrence

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Zhu, Jingjing, Wang, Fei, Shi, Liang, Cai, Hui, Zheng, Ying, Zheng, Wei, Bao, Pingping, Shu, Xiao-Ou·2020·Breast Cancer Research and Treatment
DOI 10.1007/s10549-020-05541-5PMC PMC7069792
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Abstract

Purpose To prospectively investigate accelerated aging and its association with total mortality and breast cancer-specific mortality/recurrence among breast cancer survivors. Methods This study included 4218 female breast cancer patients enrolled into a population-based cohort study approximately 6-month post-diagnosis. Information on aging-related symptoms (i.e., self-rated overall health condition, energy level, depression, sleep difficulty, and quality) was collected at 18- and 36-month post-diagnosis surveys. Information on overall health, daily function impairments, survival status, and recurrence was collected at 10-year post-diagnosis survey. Record linkages with vital statistics were conducted to collect mortality information. Cox proportional hazards model was applied. Results Among 3041 10-year survivors with a mean age of 63.7 ± 9.7 years, respectively, 52.3%, 19.0%, and 27.6% reported poor health, limitation in daily activity, and climbing floors. Age-specific prevalence revealed that breast cancer survivors reached similar prevalence of the functional limitations 5-10 years earlier than cancer-free women. At the 18-month post-diagnosis survey, respectively, 47.0%, 72.5%, and 25.1% of survivors reported unsatisfied overall health condition, reduced energy level, and depression symptoms. After a median follow-up of 10.9 years, low self-rated overall health, low energy level, and depression were significantly associated with increased total mortality, with hazard ratios (HRs; 95% confidence intervals [CI]) of 3.14 (2.43, 4.06), 1.49 (1.20, 1.84), and 1.59 (1.21, 2.09), respectively. Low self-rated health was associated with breast cancer-specific mortality/recurrence (HR 1.85, 95% CI 1.30, 2.65). No significant association was found for sleep difficulty and quality. Conclusion Aging-related physical changes/symptoms are commonly presented at 18 months after breast cancer diagnosis and are associated with worse prognosis. Impact Our findings highlight the concern of accelerated aging among breast cancer survivors.

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  • Cancer survivors are at an increased risk of developing secondary primary malignancies and non-cancer chronic diseases, such as chronic heart failure, coronary heart disease and pulmonary fibrosis, earlier and faster than the general population as a result of impaired organ function.

    “Cancer survivors are at an increased risk of developing secondary primary malignancies and non-cancer chronic diseases, such as chronic heart failure, coronary heart disease and pulmonary fibrosis, earlier and faster than the general population as a result of impaired organ function 195,196 .”

    From Senescence and cancer — role and therapeutic opportunities (2022) · cites this paper as [195]

    The Discussion reports that breast cancer survivors had more functional limitations than cancer-free women, reaching similar prevalence 5–10 years earlier. The Introduction also mentions increased comorbidity and impaired physical functioning. Neither passage establishes increased risk of second primary malignancies or the named heart and lung diseases, nor attributes their development to impaired organ function. Page numbers are unavailable in our copy. (LLM, conf=0.86)

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Cited by

Sorted by citations

Authors
Zhu, J., Wang, F., Shi, L., Cai, H., Zheng, Y., Zheng, W., Bao, P., & Shu, X.-O.
Affiliations
  • Vanderbilt-Ingram Cancer Center (US)
  • Second Hospital of Shandong University (CN)
  • Shanghai Municipal Center For Disease Control Prevention (CN)
  • Fudan University (CN)
Corresponding author
Shu, Xiao-Ou
ORCID
Venue
Breast Cancer Research and Treatment
Publisher
Springer Science and Business Media LLC
Published
2020-02-04
Volume
180
Issue
2
Pages
449-459
ISSN
  • 0167-6806 (ISSN-L)
  • 1573-7217
DOI
10.1007/s10549-020-05541-5
PMC
PMC7069792
OpenAlex
W3005101434
Cited by
31
References
8
Citations by year
2026: 2 · 2025: 9 · 2024: 1 · 2023: 2 · 2022: 10 · 2021: 4 · 2020: 3
FWCI
1.68
Type
journal article
Language
en
Open access
Licence
Locations
  • Breast Cancer Research and Treatment (publishedVersion)
  • PubMed (publishedVersion)
  • PubMed Central (acceptedVersion)
Funders
  • U.S. Department of Defense (DAMD17-02-1-0607)
  • National Cancer Institute (R01 CA118229)
Topics
  • Health Sciences › Medicine › Oncology › Cancer survivorship and care
  • Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Childhood Cancer Survivors' Quality of Life
  • Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Cancer-related cognitive impairment studies
Keywords
accelerated aging, breast cancer survivors, mortality, tumor recurrence, self-rated health, depression, energy levels, functional limitations, prognosis
MeSH terms
Cancer Survivors, Activities of Daily Living, Adult, Aged, Aging, Breast Neoplasms, Depression, Fatigue, Female, Follow-Up Studies, Humans, Sleep Initiation and Maintenance Disorders, Middle Aged, Neoplasm Recurrence, Local, Prospective Studies, Quality of Life, Risk Factors, Survival Rate, Young Adult

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