Heart risks ‘acceptable’ with breast cancer chemo

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Some types of chemotherapy are known to be potentially damaging to the heart, but for most women with breast cancer the benefits appear to outweigh the risks, French researchers report.

Dr. Jacques Bonneterre of Centre Oscar Lambret, Lille, and colleagues note in the Journal of Clinical Oncology that the widespread use of a class of chemo drugs called anthracyclines for breast cancer has raised concerns about cardiac toxicity. 

These drugs, which include epirubicin, can result in congestive heart failure. However, Bonneterre told Reuters Health, “At the total dose used, epirubicin cardiotoxicity is very limited and manageable.”

To look into this issue, the researchers followed 150 women with breast cancer who had received chemotherapy consisting of six cycles of fluorouracil, cyclophosphamide along with various doses of epirubicin.

After an average of more than 8 years, 5 of the 85 patients who had received the highest dose of epirubicin had reduced heart function, and two had congestive heart failure that may have been related to the chemo.

With appropriate patient selection, the investigators conclude, the risk of cardiotoxicity with relatively high epirubicin doses “is acceptable” and does not lead to cardiac damage “that would outweigh the expected benefits.”

SOURCE: Journal of Clinical Oncology, August 2004.

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