Metastatic breast cancer and heart health

If you are living with metastaticinfo-icon breast cancer, you may experience heart problems as a result of taking certain medicines. Though rare, these may include

  • swelling of the heart muscle
  • congestive heart failure, when the heart doesn’t pumpinfo-icon blood as well as it should
  • heart disease

You may manage your heart health differently than a woman with early-stage breast cancerinfo-icon. Living with metastatic disease means you will be in ongoing treatment and will actively deal with potential side effects for the rest of your life.

How Does Long-Term Treatment Impact the Heart?

Long-term treatment may increase the risk of heart problems. Talk with your doctor about regular tests for heart damage, especially if you had these types of treatment:

  • High doses of certain chemotherapy medicines, especially anthracyclines. These treatments can weaken the left ventricle, the heart’s main pumping chamber, which can lead to heart failure.
  • Targeted therapies used to treat HER2-positive, metastaticinfo-icon breast cancer. These medicines carry a higher risk for congestive heart failure, especially when combined with anthracyclineinfo-icon chemotherapyinfo-icon.
  • The sequence of anthracyline chemotherapy followed by the targeted therapyinfo-icon trastuzumab (Herceptin). This combination treatment, which is often used to treat metastatic disease, can cause heart failure in up to 27 percent of people taking it.

How Can I Prevent Heart Damage?

To prevent heart damage, your doctor will try to make sure that over the course of your treatment you get only the amount of medicineinfo-icon considered safe for heart health. If you have chest pain or other symptoms of heart problems while you’re taking one of these treatments, report them to your care team. Research to make chemotherapyinfo-icon less dangerous for the heart is under way.

What If Treatment Causes Heart Damage?

If a treatment causes heart problems, your doctor may:

  • give you medicines to manage symptoms and strengthen your heart. Be sure to use all medicines as directed, even when the symptoms improve, to prevent the side effectinfo-icon from worsening again
  • lower the doseinfo-icon of the medicineinfo-icon causing them
  • give you the treatment less often
  • switch you to a different medicine to stop symptoms from getting worse
  • give you a treatment break, where you temporarily stop treatment with the medicine causing heart problems in order to ease symptoms

Goals of your treatment are to keep the cancer under control for as long as possible and to maintain your quality of lifeinfo-icon. You don’t have to stay on any treatment that lessens your quality of life, including causing damage to your heart.  

Remember, your needs are an important part of your treatment plan. You and your doctor will decide together whether continuing with a treatment is right for you.

March 1, 2019