BACKGROUND The focus on noncancer causes of death in patients with breast cancer (BC) remains superficial. The objective of the current study was to assess and quantify causes of death after BC diagnosis. METHODS In total, 754,270 women with BC in the United States who were diagnosed during 2000 through 2015 and retrieved from the Surveillance, Epidemiology, and End Results (SEER) program were studied. Standardized mortality ratios (SMRs) for causes of death were calculated. RESULTS Of the included patients, 183,002 (24.3%) died during the follow-up period. The greatest proportion of deaths (46.2%) occurred within 1 to 5 years after diagnosis. Most deaths occurred from BC itself or from other cancers, and the number of BC deaths decreased as more years passed after diagnosis. The most common noncancer causes of death within <10 years after diagnosis were heart diseases followed by cerebrovascular diseases. However, >10 years after diagnosis, the most common noncancer causes of death were heart diseases followed by Alzheimer disease. Patients had a statistically significant higher risk of death from chronic liver diseases within 5 to 10 years after diagnosis compared with the general population (SMR, 1.23; 95% CI, 1.09-1.38) and had statistically significant higher risks of death from Alzheimer disease (SMR, 1.21; 95% CI, 1.14-1.29) and from diseases of the heart (SMR, 1.06; 95% CI, 1.02-1.09) >10 years after diagnosis. CONCLUSIONS Although BC remains the most common cause of death after BC diagnosis, other non-BC causes of death (mainly heart and cerebrovascular diseases) represent a significant number of deaths among patients with BC. These findings provide important insight into how BC survivors should be counselled regarding future health risks.

中文翻译：

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乳腺癌诊断后的死亡原因：基于美国人群的分析。

背景技术对乳腺癌（BC）患者的非癌症死亡原因的关注仍然是肤浅的。本研究的目的是评估和量化BC诊断后的死亡原因。方法研究了2000年至2015年在美国被诊断并从监测，流行病学和最终结果（SEER）程序中检索到的754,270名患有BC的女性。计算了死亡原因的标准死亡率（SMR）。结果在随访的患者中，有183,002名（24.3％）死亡。死亡的最大比例（46.2％）发生在诊断后的1至5年内。大多数死亡是由BC本身或其他癌症引起的，随着诊断后的过去，BC死亡人数减少了。< 确诊后10年，心脏病继之于脑血管疾病。但是，在诊断后10年以上，最常见的非癌性死亡原因是心脏病，其次是阿尔茨海默氏病。与一般人群相比，患者在诊断后5至10年内因慢性肝病而死亡的统计学意义较高（SMR，1.23； 95％CI，1.09-1.38），并且因阿尔茨海默病而具有统计学意义的较高死亡风险（SMR，1.23； 95％CI，1.09-1.38）。 SMR，1.21； 95％CI，1.14-1.29）和心脏病诊断后（> 10年）（SMR，1.06； 95％CI，1.02-1.09）。结论尽管BC仍然是BC诊断后最常见的死亡原因，但是在BC患者中，其他非BC死亡原因（主要是心脏和脑血管疾病）也代表了大量死亡。