Cardiovascular Comorbidities and Cancer-Directed Therapies in Hispanic Breast Cancer Patients: A Two-Center Analysis from the Southwestern U.S

Tomas Escobar Gil^1*Emily Sherry²Alexandra Claire Millhuff¹Victoria Ayodele²Aymen Baig²Oscar Felipe Borja Montes¹Valeria Hanson¹Jacklyn Marie Nemunaitis³Marcela Mazo Canola⁴

• ¹University of New Mexico, Albuquerque, United States
• ²The University of Texas Health Science Center at San Antonio, San Antonio, United States
• ³The University of New Mexico Comprehensive Cancer Center, Albuquerque, United States
• ⁴The University of Texas Health Science Center at San Antonio Mays Cancer Center, San Antonio, United States

Background: Cardiovascular disease (CVD) is a leading cause of mortality among breast cancer survivors and disproportionately affects Hispanic women due to a high burden of comorbidities and treatment-related toxicities. Real-world cardiovascular risk and treatment patterns in this population, particularly in the Southwestern United States, remain under-characterized. Methods: We conducted a retrospective review of 394 self-identified Hispanic patients with stage I–III breast cancer treated with curative intent between 2022 and 2023 at two academic cancer centers in the Southwestern U.S. Data included demographics, tumor characteristics, cancer therapy, cardiovascular comorbidities, and medication use. Descriptive statistics were used to summarize findings; no hypothesis testing was performed, as the study was designed to characterize patterns rather than infer causality. Results: The cohort had a mean age of 59.9 years and a mean BMI of 30.1 kg/m². Cardiovascular comorbidities were present in 57.5% of patients, a proportion higher than previously reported breast cancer cohorts (~40%). Hypertension (45.7%) and diabetes (24.3%) were also more common than national estimates. Among hypertensive patients, 73.9% were on antihypertensives, slightly lower than published rates (~77%), whereas 94.2% of patients with hyperlipidemia were on statins, exceeding prior estimates (~70%). All patients with CVD received aspirin. Chemotherapy was administered to 66% of the cohort, a higher rate than prior Hispanic breast cancer studies (~48%). Anthracycline use (19.2%) was consistent with national de-escalation trends. Conclusion: Hispanic patients with breast cancer in the Southwestern U.S. experience a high burden of cardiovascular disease, with a lower proportion of antihypertensive use and higher statin use compared with prior reports. Implications for Practice: These findings highlight important care gaps that may compound treatment-related toxicities, particularly with anthracyclines. By describing real-world patterns from two Southwestern institutions, this study underscores the need for integrated cardio-oncology models tailored to Hispanic populations. Institutional and regional variability further suggests opportunities for quality improvement, patient education, and early intervention to reduce long-term morbidity in this underserved group.