BACKGROUND Breast cancer (BC) survivors are at increased risk of cardiovascular disease (CVD) due to shared risk factors with BC and cardiotoxic treatment effects. We aim to investigate racial differences in mortality due to CVD and BC among women diagnosed with invasive BC. METHODS Data from 407 587 non-Hispanic Black (NHB) and White (NHW) women diagnosed with malignant BC (1990-2014) were obtained from the Surveillance, Epidemiology, and End Results database. Cumulative incidence of mortality due to CVD and BC was calculated by race and age (years). Cox models were used to obtain hazard ratios (HR) and 95% confidence intervals (95%CI) for the association of race/ethnicity with cause-specific mortality. RESULTS The 20-year cumulative incidence of CVD-related mortality was higher among younger NHBs than NHWs (e.g. age 55-69: 13.3% vs 8.9%, respectively). NHBs had higher incidence of BC-specific mortality than NHWs, regardless of age. There was a monotonic reduction in CVD-related mortality disparities with increasing age (age <55: HR = 3.71, 95%CI: 3.29, 4.19; age 55-68: HR = 2.31, 95%CI: 2.15, 2.49; age 69+: HR = 1.24, 95%CI: 1.19, 1.30). The hazard of BC-specific mortality among NHBs was approximately twice that of NHWs (e.g. age <55: HR = 1.98, 95%CI: 1.92, 2.04). CONCLUSIONS There are substantial differences in mortality due to CVD and BC between NHB and NHW women diagnosed with invasive BC. Racial differences were greatest among younger women for CVD-related mortality and similar across age groups for BC-specific mortality. Future studies should identify pathways through which race/ethnicity affects cause-specific mortality, to inform efforts towards reducing disparities.

中文翻译：

---

被诊断患有浸润性乳腺癌的美国女性心血管疾病和乳腺癌死亡率的种族差异。


背景：由于乳腺癌（BC）共有的危险因素和心脏毒性治疗作用，乳腺癌（BC）幸存者患心血管疾病（CVD）的风险增加。我们的目的是调查被诊断患有侵袭性 BC 的女性因 CVD 和 BC 导致的死亡率的种族差异。方法 从监测、流行病学和最终结果数据库中获取 407 587 名被诊断患有恶性 BC 的非西班牙裔黑人 (NHB) 和白人 (NHW) 女性（1990-2014 年）的数据。 CVD 和 BC 死亡率的累积发生率按种族和年龄（岁）计算。 Cox 模型用于获得种族/族裔与特定原因死亡率之间关系的风险比 (HR) 和 95% 置信区间 (95%CI)。结果 年轻 NHB 中 CVD 相关死亡率的 20 年累积发生率高于 NHW（例如，55-69 岁：分别为 13.3% 和 8.9%）。无论年龄大小，NHB 的 BC 特异性死亡率均高于 NHW。随着年龄的增加，CVD相关死亡率差异呈单调下降趋势（年龄<55：HR = 3.71，95%CI：3.29，4.19；55-68岁：HR = 2.31，95%CI：2.15，2.49；69岁+：HR = 1.24，95%CI：1.19，1.30）。 NHB 中 BC 特异性死亡率的风险大约是 NHW 的两倍（例如，年龄 <55：HR = 1.98，95%CI：1.92、2.04）。结论 被诊断患有侵袭性 BC 的 NHB 和 NHW 女性因 CVD 和 BC 导致的死亡率存在显着差异。与 CVD 相关的死亡率的种族差异在年轻女性中最大，而不同年龄组的 BC 特定死亡率的种族差异也相似。未来的研究应确定种族/族裔影响特定原因死亡率的途径，为减少差异的努力提供信息。