Key result
Hypertension is linked to markedly higher baseline cardiotoxicity risk before breast cancer therapy.
Why the study?
Breast cancer chemotherapy or radiotherapy exposes patients to cardiotoxicity risk, which can be assessed pre-therapeutically using the HFA-ICOS score.
Cross-Sectional (n=130)
Yes
Odds Ratio: 27.1 (95% CI 7.51–97.76)
p-value: p=<0.001
In Cameroonian women with breast cancer, the pre-treatment risk of cardiotoxicity based on the HFA-ICOS score is generally low, though age ≥60, obesity, and hypertension significantly increase the risk of moderate to severe cardiotoxicity.
HFA-ICOS stratification in Cameroonian breast cancer patients remains hypothesis-generating; prospective validation is needed before clinical adoption.
BACKGROUND: Treatment of breast cancer by chemotherapy or radiotherapy exposes the patient to the risk of cardiotoxicity, which can be assessed pre-therapeutically using scores such as the Heart Failure Association and International Cardio-Oncology Society (HFA-ICOS) score. We aimed to evaluate the risk of cardiotoxicity using the HFA-ICOS score in a group of Cameroonian women before treatment of breast cancer by chemotherapy and/or radiotherapy. METHODS: We conducted a cross-sectional analytic study using retrospective data collected from the Cardiology and Oncology departments at Yaounde Central Hospital and the Internal Medicine department at Yaounde General Hospital over an eight-year period, from 2017 to 2024, with a focus on the nine months from November 2023 to June 2024. Inclusion criteria consisted of patients with histologically confirmed breast cancer treated with chemotherapy and/or radiotherapy. We performed a multivariate analysis to determine the factors associated with moderate and high risk of cardiotoxicity, with a significance threshold of p ≤ 0.05. RESULTS: Of the 130 patients recruited, the median age was 46.5 years (interquartile range, IQR, 36.75-58.00), with extremes of 21 and 76 years. Comorbidities mainly were overweight/obesity in 92 (70.7%) cases and arterial hypertension in 32 (24.6%) cases. Invasive ductal carcinoma was the main histological type, accounting for 126 (96.9%) cases, and triple-negative carcinoma was the most frequent molecular subtype, comprising 55 (42.3%) cases. Treatment consisted of exclusive chemotherapy in 96 (73.8%) cases and radiotherapy associated with chemotherapy in 27 (20.8%) cases. Based on the HFA-ICOS score, the cardiotoxicity risk was low in 93 (71.5%) patients. The independent factors associated with the risk of moderate to severe cardiotoxicity were age ≥ 60 years (adjusted OR: 5.97; 95% CI 1.73-20.60; adjusted p = 0.005), obesity (adjusted OR: 5.81; 95% CI 1.78-18.91; p = 0.003) and hypertension (adjusted OR: 27.10; 95% CI 7.51-97.76; p < 0.001). Exclusive chemotherapy was a protective factor (adjusted OR: 0.24; 95% CI 0.07-0.81; adjusted p = 0.021). CONCLUSION: Women with breast cancer in Cameroon tend to be relatively young and present a low risk of cardiotoxicity before starting anti-cancer treatment.
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Nganou–Gnindjio et al. (2025) conducted a cross-sectional in Breast cancer (n=130). Arterial hypertension vs. Absence of arterial hypertension was evaluated on Moderate to high risk of cardiotoxicity based on the HFA-ICOS score (OR 27.10, 95% CI 7.51-97.76, p=<0.001). Arterial hypertension was independently associated with a significantly increased risk of moderate to severe baseline cardiotoxicity (OR 27.10) in Cameroonian women prior to breast cancer treatment.
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