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Review
. 2024 Jun;27(3):147-162.
doi: 10.4048/jbc.2024.0085. Epub 2024 Apr 29.

Breast Cancer and Therapy-Related Cardiovascular Toxicity

Hui-Jeong Hwang  1 , Sang-Ah Han  2 , Il Suk Sohn  3
Affiliations
Review

Breast Cancer and Therapy-Related Cardiovascular Toxicity

Hui-Jeong Hwang et al. J Breast Cancer. 2024 Jun.

Abstract

The global incidence of breast cancer is on the rise, a trend also observed in South Korea. However, thanks to the rapid advancements in anticancer therapies, survival rates are improving. Consequently, post-treatment health and quality of life for breast cancer survivors are emerging as significant concerns, particularly regarding treatment-related cardiotoxicity. In this review, we delve into the cardiovascular complications associated with breast cancer treatment, explore surveillance protocols for early detection and diagnosis of late complications, and discuss protective strategies against cardiotoxicity in breast cancer patients undergoing anticancer therapy, drawing from multiple guidelines.

Keywords: Anthracyclines; Breast Neoplasms; Cardiotoxicity; Echocardiography; Trastuzumab.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Figure 1
Figure 1. Collaborative approach strategy for cardiotoxicity monitoring.
CV = cardiovascular; DM = diabetes mellitus; HT = hypertension; CVD = cardiovascular disease; HF = heart failure; VHD = valvular heart disease; CAD = coronary artery disease; LVEF = left ventricular ejection fraction; AC = anthracycline; RT = radiotherapy; DOX = doxorubicin; ECG = electrocardiography; TTE = transthoracic echocardiography; cTn = cardiac troponin; NP = natriuretic peptide. *In anthracycline and anti-human epidermal growth factor 2 therapies; †If CV toxicity develops.
Figure 2
Figure 2. Assessment of cardiac function on echocardiography: left ventricular ejection fraction and global longitudinal strain.
LVEF = left ventricular ejection fraction; GLS = global longitudinal strain; Ai, Bi = cylinder volumes, L = left ventricular longitudinal diameter; Ld = length at diastolic period; Ls = length at systolic period; V = volume; n = number of cylinders; EDV = end-diastolic volume; ESV = end-systolic volume.
Figure 3
Figure 3. Serial transthoracic echocardiography of a 60-year-old female with breast cancer undergoing doxorubicin-docetaxel chemotherapy. (A) Baseline TTE, (B) TTE 3 months later.
TTE = transthoracic echocardiography; ANT_SEPT = anteroseptal; SEPT = septal; ANT = anterior; INF = inferior; POST = posterior; LAT = lateral; GLS = global longitudinal strain; LVEF = left ventricular ejection fraction; cTn = cardiac troponin; Δ = change.
See this image and copyright information in PMC

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