A 63-year-old woman developed late-onset heart failure with an ejection fraction of 20% and enlarged left ventricle 14 years after anthracycline chemotherapy for breast cancer.
This case highlights the critical need for long-term cardiac monitoring in cancer survivors treated with anthracyclines due to the risk of late-onset heart failure.
Anthracyclines are drugs used to treat various types of cancers, including breast cancer. They are still among the most effective anticancer drugs used today and their broad use has dramatically improved cancer survival statistics. Unfortunately, though mortality rates decrease with their use, life-altering cardiac sequelae from anthracyclines remain a problem, such as patients developing late-onset heart failure secondary to anthracycline-induced cardiotoxicity (AIC). We present a case of 63-year-old female who was admitted to the Cardiology Clinic due to the symptoms of heart failure. Fourteen years earlier she had a left-sided mastectomy due to breast cancer treated with radiotherapy and chemotherapy. The chemotherapy regime was FAC (5-fluorouracil, doxorubicin and cyclophosphamide). Echocardiogram showed enlarged left ventricle (58mm/51mm), with reduced ejection fraction (EF 20%). There was a large effusion in the left pleura. This finding was primarily related to the treatment of breast cancer with chemotherapy.
Popović et al. (2023) studied this question. A 63-year-old woman developed late-onset heart failure with an ejection fraction of 20% and enlarged left ventricle 14 years after anthracycline chemotherapy for breast cancer.