Heart group warns of cardiovascular risks after treatment for breast cancer

(Sharon Begley/ Stat) — Cardiologists are not telling women with breast cancer to decline treatment — far from it. But in its first-ever statement on the most common female cancer, the American Heart Association has warned that breast cancer survivors, especially those treated with common chemotherapies, are at increased risk for heart failure and other cardiovascular diseases. And it called on cancer doctors to weigh the benefits of those treatments against the heart risks they pose.

It has been known for years that some breast cancer drugs (including some also used for other cancers) can weaken the heart muscle, causing heart failure. But the group of heart doctors is concerned that if heart symptoms arise years after cancer treatment, the link to chemo may be missed.

An older class of drugs called anthracyclines, which includes doxorubicin, can kill cardiomyocytes, which make up the heart muscle, especially in older women or those with pre-existing heart disease. Taxanes, such as paclitaxel, can cause an abnormally slow heart rhythm, while hormone drugs such as tamoxifen can cause potentially fatal thromboembolisms, or blood clots. The aromatase inhibitor anastrozole has been linked to heart attacks and other cardiovascular events. Trastuzumab (Herceptin) can cause heart failure, especially in women over 50 and those with underlying heart disease or hypertension. (…)

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