Adjuvant breast cancer treatments cardiotoxicity and modern methods of detection and prevention of cardiac complications

Agata Bikiewicz, Maciej Banach, Stephan von Haehling, Marek Maciejewski, Agata Bielecka-Dabrowa, Agata Bikiewicz, Maciej Banach, Stephan von Haehling, Marek Maciejewski, Agata Bielecka-Dabrowa

Abstract

The most common cancer diagnosis in female population is breast cancer, which affects every year about 2.0 million women worldwide. In recent years, significant progress has been made in oncological therapy, in systemic treatment, and in radiotherapy of breast cancer. Unfortunately, the improvement in the effectiveness of oncological treatment and prolonging patients' life span is associated with more frequent occurrence of organ complications, which are side effects of this treatment. Current recommendations suggest a periodic monitoring of the cardiovascular system in course of oncological treatment. The monitoring includes the assessment of occurrence of risk factors for cardiovascular diseases in combination with the evaluation of the left ventricular systolic function using echocardiography and electrocardiography as well as with the analysis of the concentration of cardiac biomarkers. The aim of this review was critical assessment of the breast cancer therapy cardiotoxicity and the analysis of methods its detections. The new cardio-specific biomarkers in serum, the development of modern imaging techniques (Global Longitudinal Strain and Three-Dimensional Left Ventricular Ejection Fraction) and genotyping, and especially their combined use, may become a useful tool for identifying patients at risk of developing cardiotoxicity, who require further cardiovascular monitoring or cardioprotective therapy.

Keywords: Biomarkers; Breast cancer; Cardiotoxicity; Heart failure; Oncological treatment.

Conflict of interest statement

The authors declare no conflict of interest.

© 2021 The Authors. ESC Heart Failure published by John Wiley & Sons Ltd on behalf of European Society of Cardiology.

Figures

Figure 1
Figure 1
Actions of anthracyclines in the cell. After entering the cell, anthracyclines (AC) cause mitochondrial damage and disrupt transcription in nuclear DNA.

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