The Cardiac Outcomes with Near-complete Estrogen Deprivation (CROWN) Study

Understanding the cardiovascular impact of near complete estrogen deprivation (NCED) in young women with breast cancer.

Site Principal Investigator: Susan Dent, MD, Co-Director Duke Cardio-Oncology Program

The Problem

Over the past two decades, the rates of women with hormone receptor-positive breast cancer have increased. However, survival rates for women with this type of breast cancer have improved when the treatment involves estrogen depletion to stop cancer cells from growing. Estrogen keeps blood vessels healthy and protects women from heart disease, but the long-term effect of estrogen depletion in young breast cancer survivors puts them at increased risk of heart disease, including heart failure and heart attacks.

The Solution

Duke Cancer Institute is collaborating with Wake Forest University Health Sciences - Wake Forest Baptist Comprehensive Cancer Center and Virginia Commonwealth University Massey Cancer Center in a “first-of-its-kind prospective study to look for the earliest signs of heart vessel damage in young, pre-menopausal breast cancer survivors.

90 women, age 55 and under, who have been diagnosed with breast cancer, will be enrolled at all three centers and will receive state-of-the-art cardiovascular imaging tests (Cardiac MRI stress test and CT angiogram) at different time points to look for changes in the blood vessels that supply blood to the heart. The study will also include blood tests to look for biomarkers that correlate with the risk of cardiovascular disease.

The Goal

This study will provide a better understanding of the cardiovascular consequences of breast cancer treatments so that we don’t offset the gains we have made in breast cancer survival with early-onset cardiovascular disease.