Key result
Multiple systemic breast cancer therapies carry significant cardiotoxicity risks, warranting routine cardiovascular monitoring.
Why the study?
Treatments for breast cancer can cause serious cardiovascular side effects affecting quality of life, morbidity, and mortality, warranting a review of their toxicity, underlying mechanisms, risk assessment, and clinical management.
This review highlights the critical need for cardiovascular risk assessment, prevention programs, and management of cardiotoxicity to improve morbidity and mortality in breast cancer survivors.
May warrant CV monitoring during breast cancer therapy; leaves open optimal protocols and outcomes from prospective trials.
Cardiovascular diseases are largely represented in patients with cancer and appear to be important side effects of cancer treatments, heavily affecting quality of life and leading to premature morbidity and death among cancer survivors. In particular, treatments for breast cancer have been shown to potentially play serious detrimental effects on cardiovascular health. This review aims to explore the available literature on breast cancer therapy-induced side effects on heart and vessels, illustrating the molecular mechanisms of cardiotoxicity known so far. Moreover, principles of cardiovascular risk assessment and management of cardiotoxicity in clinical practice will also be elucidated. Chemotherapy (anthracycline, taxanes, cyclophosphamide and 5-fluorouracil), hormonal therapy (estrogen receptor modulator and gonadotropin or luteinizing releasing hormone agonists) and targeted therapy (epidermal growth factor receptor 2 and Cyclin-dependent kinases 4 and 6 inhibitors) adverse events include arterial and pulmonary hypertension, supraventricular and ventricular arrhythmias, systolic and diastolic cardiac dysfunction and coronary artery diseases due to different and still not well-dissected molecular pathways. Therefore, cardiovascular prevention programs and treatment of cardiotoxicity appear to be crucial to improve morbidity and mortality of cancer survivors.
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Lanza et al. (2022) conducted a review in Breast Cancer. Breast cancer therapies (chemotherapy, hormonal therapy, targeted therapy) was evaluated. Systemic breast cancer treatments, including anthracyclines, taxanes, hormonal therapies, and targeted therapies, carry significant risks of cardiotoxicity, necessitating cardiovascular monitoring.
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