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

P J Barrett-Lee, J M Dixon, C Farrell, A Jones, R Leonard, N Murray, C Palmieri, C J Plummer, A Stanley, M W Verrill

Research output: Contribution to journalArticlepeer-review


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.
Original languageEnglish
Pages (from-to)816-27
Number of pages12
JournalAnnals of Oncology
Issue number5
Publication statusPublished - May 2009


  • Anthracyclines
  • Antibiotics, Antineoplastic
  • Breast Neoplasms
  • Dose-Response Relationship, Drug
  • Drug Monitoring
  • Female
  • Heart Diseases
  • Humans
  • Patient Selection
  • Practice Guidelines as Topic
  • Risk Assessment
  • Risk Factors


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