Cardiotoxicity Risk Prediction in Breast Cancer Patients

Abstract

S. M. Kozhukhov1, N. V. Dovganych1, I. I. Smolanka2, O. F. Lygyrda2, О. Ye. Bazyka1, S. A. Lyalkin2, O. M. Ivankova2, O. A. Yarinkina1, N. V. Tkhor1 1 National Scientific Center «The M.D. Strazhesko Institute of Cardiology», 5 Narodnoho Opolchennia Str., Kyiv, 03680, Ukraine 2 National Cancer Institute of the Ministry of Health of Ukraine, 33/43 Lomonosova Str., Kyiv, 03022, Ukraine CARDIOTOXICITY RISK PREDICTION IN BREAST CANCER PATIENTS Breast cancer patients receive combined antitumor treatment (surgery, chemotherapy, targeted drugs and radiation), so they are considered to be the patients with potentially high risk of cardiotoxicity (CT). Risk stratification of cardiovascular complications before the beginning and during the cancer treatment is an important issue. Objective: to develop a CT risk model score taking into account cardiological, oncological and individual risks. Material and methods. The study included 52 breast cancer patients with retrospective analysis of their medical history, risk factors, and echocardiographic parameters before the onset and in 12 months follow up. Based on the analysis of the data, a CT risk model score was developed and recommended. The patients were divided into groups according to the score: Group 1 – low risk of CT development – score ≤ 4 points, Group 2 – moderate risk – 5–7 points, Group 3 – high risk ≥ 8 points. According to the scale, BC patients with a total of ≥ 8 points are considered to be at high risk for CT complications. Radiation therapy and anthracyclines, as well as associated cardiovascular diseases were the most important risk factors of CT. Results. Based on the study of retrospective analysis of risk factors, data of heart function monitoring during follow-up, the risk model score of cardiotoxicity has been developed for the BC patients’ stratification. According to the proposed score risk model, BC patients with a total score of ≥ 8 points considered to have high risk of cardiotoxic complications. Conclusions. Using of the proposed risk model score with calculation of CT risk factors both before the beginning and during cancer therapy is important, because it allows predicting the risk of CT development – to identify highrisk patients, accordingly, to develop an individualized plan for cardiac function monitoring and to start timely cardioprotective therapy. Key words: breast cancer, cardiotoxicity, heart failure, risk scale, prognosis.

Living with Advanced Breast Cancer: A Descriptive Analysis of Survivorship Strategies

“…As survivorship extends the lives of patients, managing the cardiovascular health of breast cancer survivors will come to the forefront of their care plan. Strategic surveillance methods, such as periodic left ventricular ejection fraction (LVEF) assessments [ 32 ], or novel risk assessment scoring tools like the one developed by Kozhukov et al [ 33 ], must be employed to ensure proper identification of these side effects.…”

Quantification of Coronary Artery Atherosclerotic Burden and Muscle Mass: Exploratory Comparison of Two Freely Available Software Programs

“…Muscle mass loss and sarcopenia onset during chemotherapy or cancer progression has been reported to have a negative effect on prognosis and on complication onset [8][9][10][11][12][13][14][15][16][17][18][19][20][21]. Some drugs used in chemotherapy are related to cardiotoxicity as well [48][49][50][51][52]. Patients treated with these drugs usually undergo echocardiography or magnetic resonance for strain and ejection fraction measurement during follow up for cardiac functionality modification [53][54][55][56][57], but CAC scoring can be feasible as well for cardiac injury monitoring during chemotherapy [34,58,59].…”

Cancer and War in Ukraine

“… 4 Recommendations and standards of treatment for cardiovascular complications during anti-tumor therapy and in long-term follow-up were developed and implemented. 5 Thus, a well-established system of medical care for oncological patients was organized.…”