Background: Cardiovascular disease and breast cancer share multiple risk factors and oncological treatment could worsen preexisting cardiovascular abnormalities, thus inducing cardio toxicity in breast cancer survivors. Methods: Gynecologists and cardiologists elaborated a score to identify patients at risk of developing chemotherapy related cardio toxicity and to monitor their cardiac function. 84 consecutive patients were enrolled in a prospective, observational study. An Individual Cardiovascular Risk (CVR) and Specific Treatment–related CVR were calculated to define a Global CVR (low, mild or high) for every patient. An electrocardiogram and an echocardiography were performed every three months from the beginning of the chemotherapy (baseline) up to 18 months. Patients with mild or high Global CVR required also a cardiologic evaluation before starting chemotherapy. RESULTS Global CVR resulted low in 18 (21.4%), mild in 63 (75%) and high in 3 patients (3.6%). Fourteen patients experienced a cardiac event (17.2%): they all belonged to the mild CVR group (14/63 patients, 22.6%). Chemotherapy was discontinued only in one patient due to heart failure. The majority of breast cancer patients have a mild global CVR and chemotherapy plays a major role in its definition. Conclusions: The majority of breast cancer patients have a mild global CVR and the chemotherapy schedule plays a major role in its definition. Minimizing long-term chemotherapy related cardio toxicity is important, considering the number of breast cancer patients whose life expectancy is increasing.
Chemotherapy-Induced Cardio Toxicity in Breast Cancer Survivors
Ferrero A
2017-01-01
Abstract
Background: Cardiovascular disease and breast cancer share multiple risk factors and oncological treatment could worsen preexisting cardiovascular abnormalities, thus inducing cardio toxicity in breast cancer survivors. Methods: Gynecologists and cardiologists elaborated a score to identify patients at risk of developing chemotherapy related cardio toxicity and to monitor their cardiac function. 84 consecutive patients were enrolled in a prospective, observational study. An Individual Cardiovascular Risk (CVR) and Specific Treatment–related CVR were calculated to define a Global CVR (low, mild or high) for every patient. An electrocardiogram and an echocardiography were performed every three months from the beginning of the chemotherapy (baseline) up to 18 months. Patients with mild or high Global CVR required also a cardiologic evaluation before starting chemotherapy. RESULTS Global CVR resulted low in 18 (21.4%), mild in 63 (75%) and high in 3 patients (3.6%). Fourteen patients experienced a cardiac event (17.2%): they all belonged to the mild CVR group (14/63 patients, 22.6%). Chemotherapy was discontinued only in one patient due to heart failure. The majority of breast cancer patients have a mild global CVR and chemotherapy plays a major role in its definition. Conclusions: The majority of breast cancer patients have a mild global CVR and the chemotherapy schedule plays a major role in its definition. Minimizing long-term chemotherapy related cardio toxicity is important, considering the number of breast cancer patients whose life expectancy is increasing.
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