Development of cancer therapy-related cardiac dysfunction in anthracycline-treated breast cancer patients: a retrospective study

Cardiac dysfunction as a result of anthracycline treatment is a major concern regarding the management of patient life after therapy. The aim of the present study was to determine the clinical characteristics of cancer patients at high risk of developing cancer therapy-related cardiac dysfunction (CTRCD), in order to improve the risk management for the appropriate treatment.

This is a single-center, retrospective study of patients with breast cancer who underwent anthracycline treatment and had regular consultations with cardiologists. To investigate the incidence of CTRCD and the risk factors related to its occurrence, left ventricular ejection fraction (LVEF), cardiac troponin I (TnI), and brain natriuretic peptide (BNP) were assessed in 177 patients at the start of anthracycline treatment, and again at 3, 6, 9, and 12 months.

Eight patients (4.5%) developed CTRCD (CTRCD group). The comparisons between the CTRCD group and those without CTRCD (non-CTRCD group) showed significant differences in pre-treatment cancer stage and neutrophil/lymphocyte ratio (NLR). Multivariate analysis showed a strong association between pre-treatment cancer stage, NLR, and type of anthracycline administered (epirubicin or doxorubicin).

High NLR, the more advanced stages of cancer, and doxorubicin administration were suggested as possible risk factors for the development of CTRCD. Special attention should be warranted for patients with any of these risk factors.