Cardiovascular experts warn that some breast cancer treatments, including Adriamycin (doxorubicin), Herceptin and radiation treatment, may damage the heart, increasing the risk of fatal heart problems among breast cancer survivors.
The American Heart Association (AHA) issued a Scientific Statement on February 1, warning about the risk of heart damage from breast cancer treatments, and advising doctors to carefully monitor their effects on the heart.
The statement is an overview of the association’s current knowledge of breast cancer treatment and heart risks, and was also published in the medical journal Circulation.
The association notes that a number of recent studies have highlighted potential heart damage caused by breast cancer treatments, as well as an increased risk of death due to cardiovascular problems among breast cancer survivors.
One of the drugs, Adriamycin, and other doxorubicin-based medications used in chemotherapy can result in damage to heart cells, the AHA warns. Studies have indicated that the risk can be mitigated by administering Adriamycin slowly over time, instead of all at once. There are also signs that a drug called dexrazoxane could reduce cell damage among patients who receive high doses of Adriamycin and similar drugs, and has recently been approved for use in patients with metastatic breast cancer who have been receiving doxorubicin during chemotherapy.
The statement also notes that HER-2 targeted breast cancer treatments like Herceptin, can weaken heart muscle, resulting in heart failure. This is temporary in some cases, and function can return over time. However, in some cases it can lead to permanent heart failure. The group called for doctors to watch for signs of heart muscle weakening and to slow down or alter treatment if that occurs.
In addition to drug risks, radiation treatment can also cause problems with arteries, the statement notes. resulting in coronary artery disease or blockages.
“Any patient who is going to undergo breast cancer treatment, whether they have heart disease at the beginning or not, should be aware of the potential effects of the treatments on their heart,” Dr. Laxmi Mehta, chair of the writing group for the scientific statement, said. “This should not deter or scare patients from undergoing breast cancer treatment, but should allow them to make informed decisions with their doctor on the best cancer treatment for them.”
The American Heart Association indicates that there are about three million breast cancer survivors in the United States, and there are about 47.8 million women nationwide living with heart disease.