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Review
. 2025 Aug 9;11(1):72.
doi: 10.1186/s40959-025-00362-1.

Challenges and opportunities for improving cardiovascular health in women with breast cancer: a review

Sana Ali  1   2 , Kerri A Mullen  3   4
Affiliations
Review

Challenges and opportunities for improving cardiovascular health in women with breast cancer: a review

Sana Ali et al. Cardiooncology. .

Abstract

Background: Breast cancer survivors are at a high risk of developing cardiovascular disease (CVD) owing to cancer treatment. Breast cancer and CVD share common risk factors, necessitating CVD risk assessment along with cancer screening. This review aimed to explore the challenges and opportunities associated with promoting cardiovascular health in women with breast cancer.

Main text: Cardio-oncology is a rapidly developing discipline that focuses on identifying, monitoring, and managing CVD in cancer patients. Preventing and managing CVD in patients with breast cancer involves evaluating risk factors, initiating cardioprotective medications, and implementing cardio-oncology rehabilitation. Major barriers to cardio-oncology prevention and management include inadequate programs, sex/gender-specific issues, financial constraints, underutilization of cardiac rehabilitation (CR), determination of the appropriate time to begin CR, physical limitations, psychological issues, and social and racial disparities.

Conclusion: A preventive cardio-oncology approach; early identification of cardiotoxicity, CVD risk factors, anxiety, and depression; individualized CR programs; early CR referrals; home/community and virtual CR models; dedicated funding, resources, and personnel; a multidisciplinary team approach; and culturally tailored cardio-oncology care can be beneficial for addressing CVD health challenges and disparities in women with breast cancer.

Keywords: Breast cancer; CVD risk factors; Cardiac rehabilitation; Cardio-oncology; Cardiotoxicity; Cardiovascular health; Challenges; Prevention.

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Conflict of interest statement

Declarations. Ethics approval and consent to participate: The authors confirm that ethical approval and patient consent are not applicable to this study. Consent for publication: Not applicable. Competing interests: The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Prevention and management of cardiovascular diseases (CVD) in patients with breast cancer ACSM: American College of Sports Medicine; ACE inhibitors: angiotensin converting enzyme inhibitors; ARBs: angiotensin receptor blockers; ASCVD: atherosclerotic cardiovascular disease; BC: breast cancer; CAD: coronary artery disease; CTR-CVT: cancer treatment-related cardiovascular toxicity; CV: cardiovascular; CVD: cardiovascular diseases; DM: diabetes mellitus, HER2: human epidermal growth factor receptor 2; HF: heart failure; HFA-ICOS: Heart Failure Association-International Cardio-oncology Society HL: hyperlipidemia; HTN: hypertension; NCCN: National Comprehensive Cancer Network; PVD: peripheral vascular disease. Acknowledgements: Icon created by Wahyu Eko Prasetyo, BinikSol, & Shocho from Noun Project and picture form https://BioRender.com
Fig. 2
Fig. 2
Improving cardiovascular health in women with breast cancer: challenges, opportunities and recommendations AHA: American Heart Association; ASBC: advanced stage breast cancer; BC: breast cancer; CR: cardiac rehabilitation; CV: cardiovascular; CVD: cardiovascular diseases; EF: ejection fraction; HF: heart failure; HIIT: high-intensity interval training; HTN: hypertension, SES: socioeconomic status; VTE: venous thromboembolism. Acknowledgements: Icon created by Frenki, BusinessIcons13, Puspito, Pinky, Warunk Icon, Mrfa Studio, & Fahmi from Noun Project
See this image and copyright information in PMC

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