Retrospective study of cardiac dysfunction among breast cancer survivors: role of cardiotoxic therapy and cardiovascular risk factors

Cardiac dysfuncion is the leading cause of mortality among 10-years breast cancer survivors. A retrospective study at the University of Alabama at Birmingham evaluated 2,808 echocardiograms in 829 breast cancer survivors who underwent echocardiographic screening every two years after completion of cardiotoxic therapy (anthracylines, trastuzumab/pertuzumab, radiation). The study found that the cumulative incidence of cardiac dysfunction increased for 1.8% at two years to 15.3% at fifteen years after initiation of the therapy. Risk factors for cardiac dysfunction were non-Hispanic Black race, type of cardiotoxic therapy, use of SERMs, and precancer hypertension. Adjusted longitudinal analyses revealed an annual decline in LVEF by 0.29% (p=0.009) over 20 years from breast cancer diagnosis. The authors conclude that these findings provide evidence to support echocardiographic surveillance for several years after cardiotoxic therapy for breast cancer.