Breast Cancer Patients Undergoing Chemotherapy Not Receiving Recommended Heart Scans

Breast cancer patients undergoing treatment are not receiving the recommended amount of follow-up heart scans despite the known toxic effects of chemotherapy, a recent study suggests.

Current breast cancer treatment guidelines recommend that a patient’s heart be monitored before, during, and after chemotherapy.

“We've been seeing an increasing number of patients in the heart failure clinic following chemotherapy,” said researcher Jagdeep Singh. “This triggered our interest in finding out why and we wanted to see the scale of this problem. We were able to start doing this and evaluate treatment practices by accessing and analyzing anonymous medical records.

For the study, researchers collected medical records from the CHEMOCARE database, and analyzed 1229 breast cancer patients treated with either anthracyclines alone or in combination with trastuzumab between January 2003 and December 2014.

The results of the study found that 625 (51%) women received an echocardiogram to check if their heart function was normal before being placed on chemotherapy. Of these patients, only 238 patients (38%) had follow-up scans during treatment.

“Improvements in chemotherapy mean we've been able to transform breast cancer from an often fatal condition into a very treatable disease,” Singh said. “But, due to the real risk of heart failure, our findings show that doctors need to be more vigilant and institute protective heart treatments earlier.”

The authors concluded that communication needs to be improved among caregivers throughout the cancer treatment journey.

“Thanks to research, more women are surviving breast cancer than ever before but it is very worrying that some of them go on to develop life threatening heart disease as a consequence of their chemotherapy,” said Peter Weisberg, medical director of British Heart Foundation (BHF). “This research suggests that oncologists and cardiologists should work together from the outset to minimize the detrimental effects of chemo on the heart, while ensuring the best chance of survival from the cancer. Cardio-oncology is a new specialty which has only come about because of improved cancer survival and we hope to see greater cooperation between heart doctors and cancer doctors in the future.”