Cardiovascular disease risk among breast cancer survivors: an evolutionary concept analysis

Abstract

Background:

More than 3.5 million breast cancer survivors are living in the US, and the overall five-year survival rate is approaching 90%. With increased survival and cancer treatment-related cardiotoxicities, there has been a rise in cardiovascular diseases among breast cancer survivors. Yet, cardiovascular disease risk among breast cancer survivors has not been well conceptualized. The purpose of this article was to analyze and define the concept of cardiovascular disease risk among breast cancer survivors.

Methods:

The databases CINAHL, EMBASE, and PubMed were used to identify articles that explored cardiovascular disease risk among breast cancer survivors. The search yielded 357 articles, which were reviewed for eligibility. Thirty articles were selected based on the inclusion/exclusion criteria. The concept of cardiovascular disease risk among breast cancer survivors was analyzed using Rodgers’ evolutionary concept analysis method.

Results:

The analysis suggests that cardiovascular disease risk among breast cancer survivors consists of several attributes: cancer treatment (chemotherapy, targeted therapies, radiation therapy, and endocrine therapy), modifiable risk factors (obesity, physical inactivity, poor diet, and smoking), and nonmodifiable risk factors (age, family history, and race). The antecedent identified includes breast cancer diagnosis and the consequence identified includes the development of cardiovascular disease.

Conclusion:

Findings suggest the need for increased education and understanding of cardiovascular disease risk among health care providers and patients. Survivorship care plans can incorporate cardiovascular disease risk monitoring and screening. Future research is needed to explore interventions and develop stratified screening guidelines for breast cancer survivors.

Keywords::

• breast cancer survivors
• cardiovascular disease risk
• Rodgers’ evolutionary concept analysis method
• cancer survivorship
• cardiotoxicity

Acknowledgments

JBV was supported by doctoral study funding through the Robert Wood Johnson Future of Nursing Scholars Program (grant #72592), Susan G. Komen Graduate Training in Disparities Research Grant (GTDR-15329376), and UAB School of Nursing Doctoral Scholarship. The authors would like to acknowledge Jennifer Frank, PhD, for editorial support of this paper.

Disclosure

The authors report no conflicts of interest in this work.