Elsevier

Annals of Oncology

Volume 20, Issue 5, May 2009, Pages 816-827
Annals of Oncology

reviews
Expert opinion on the use of anthracyclines in patients with advanced breast cancer at cardiac risk

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Abstract

Anthracyclines are considered to be among the most active agents for the treatment of breast cancer. However, their use is limited by cumulative, dose-related cardiotoxicity. Such cardiotoxicity results in a permanent loss of cardiac myocytes and a progressive reduction in cardiac function following each subsequent dose of anthracycline. Initially, damage to the heart is subclinical; however, increasingly impaired cardiac function can result in cardiovascular symptoms, with serious cardiac injury resulting in chronic heart failure. Since the early detection and treatment of cardiotoxicity can reduce its clinical effects, it is important that oncologists are aware of these adverse effects and manage them appropriately. This review examines the risk factors for anthracycline-associated cardiotoxicity and offers recommendations on strategies to reduce the cardiotoxicity of anthracyclines in the management of patients with advanced breast cancer.

Keywords

advanced breast cancer
anthracyclines
cardiac monitoring
cardiotoxicity
liposomal anthracyclines
risk factors

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