Objective: This review addresses cardiotoxicity in breast cancer patients treated with anthracyclines and/or anti-HER2 therapy, namely trastuzumab; aiming to identify risk factors, clinical predictors, and define effective monitoring strategies to optimize patient care.
Methods: Clinical review articles were found through MEDLINE. The articles utilized were limited to evidence-based studies and comprehensive clinical reviews published within the last five years.
Results: Close cardiac monitoring is recommended for breast cancer patients throughout treatment with anthracyclines and anti-HER2 therapy. Pretreatment risk assessment with echocardiography and evaluation of cardiovascular risk factors aid in predicting the development of left ventricular dysfunction (LVD). During treatment, monitoring is recommended with serial imaging to follow LVEF, and optimization of cardiac risk factors. Breast cancer patients who develop cardiotoxicity should be referred to a cardio-oncology team.
Conclusion: Further clinical trials are needed to increase understanding and optimize treatment guidelines of LV dysfunction in the setting of anthracyclines or anti-HER2 therapy.
Durkin MM. Heart Failure Related to Contemporary Breast Cancer Treatment: Risk Factors, Monitoring Strategies, and Management to Optimize Outcomes. University of Lynchburg DMSc Doctoral Project Assignment Repository. 2022; 4(3).
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