Racial disparities in treatment-related cardiovascular toxicities amongst women with breast cancer: a scoping review.

PURPOSE: Black women often experience poorer breast cancer-related outcomes and higher mortality than white women. A contributor to this disparity may relate to the disproportionate burden of cancer treatment-related cardiovascular (CV) toxicities. The objective of this review is to identify studies that report racial differences in CV toxicity risk. METHODS: Medline and Embase were searched for studies that assessed CV toxicities as the outcome(s) and included Black and White women with breast cancer. Studies were selected based on inclusion/exclusion criteria and through the use of multiple reviewers. RESULTS: The review included 13 studies following a review of 409 citations and 49 full-text articles. All studies were retrospective and 8/13 utilized data from the Surveillance, Epidemiology, and End Results-Medicare linked database. Trastuzumab was the most frequently studied treatment. The proportion of Black women in these studies ranged from 5.5 to 63%. A majority of studies reported a higher risk of CV toxicity amongst Black women when compared to white women (93%). Black women had up to a two times higher risk of CV toxicity (HR, 2.73 (CI, 1.24 to 6.01)) compared to white women. Only one study evaluated the role of socioeconomic factors in explaining racial differences in CV toxicity; however, the disparity remained even after adjusting for these factors. CONCLUSIONS: There is a critical need for more longitudinal studies that evaluate multilevel factors (e.g., psychosocial, biological) that may help to explain this disparity. IMPLICATIONS FOR CANCER SURVIVORS: Black cancer survivors may require additional surveillance and mitigation strategies to decrease disproportionate burden of CV toxicities.

Bone health, muscle properties and stretch-shortening cycle function of young and elderly males.

The aim of this study was to examine bone, muscle, strength and stretch-shortening cycle (SSC) performance in young and elderly individuals with an ankle model to elucidate potential effects of ageing that have been suggested to influence fall risk. Moderately active young (n=10; age=22.3±1.3 yrs) and elderly (n=8; age=67.5±3.3 yrs) males completed a peripheral quantitative computed tomography scan on the dominant lower leg, maximal voluntary isometric plantarflexions (MVIP) and SSC tasks: a countermovement hop and drop hops from three different heights. Bone stress-strain index at 14% of the lower leg and muscle density, muscle cross-sectional area and muscle+bone cross-sectional area at 66% of the lower leg were all significantly greater (p≤0.05) in younger males than elderly males. Younger males also had significantly greater rate of force development and peak force during the MVIP when compared to the elderly. Younger males achieved significantly higher forces, velocities and hop heights during all SSC tasks than elderly males. Such information provides support for greater specificity in exercise interventions that prevent lower leg morphological and functional decrements in the ageing population.