title: Cardiac toxicity in breast cancer patients: from a fractional point of view to a global assessment.
abstract: When focusing on heart disease, most available studies split the two different parts of the adjuvant treatment, i.e., systemic therapies and radiation therapy, making it difficult to implement efficient strategies for preventing treatment-induced cardiac toxicity. This paper reviews the current understanding of treatments-induced cardiac toxicity in a global approach. Many factors should be considered when assessing the cardiac hazard. Treatment-related risk factors include heart dose exposure, chemotherapy, targeted agents such as HER2 inhibitors, but also endocrine agents, or anesthetic procedure. Patients' characteristics should also be taken into account. Age, menopausal status, stress, previous history of cardiac disease, genetic profile, and body mass index could all impact on cardiac function after adjuvant therapies. Cardiac toxicity should not be analyzed as the consequence of a specific therapy, but should be considered as the result of additive or supra-additive toxicities. By this way, it will be possible to implement new strategies for preventing treatment-induced cardiac toxicity.
authors.affiliation: Service d'Oncologie Radiothérapie, Hôpital d'Instruction des Armées du Val-de-Grâce, France. chargari-vdg@hotmail.fr
authors.forename: Cyrus
authors.initials: C
authors.lastname: Chargari
authors.forename: Krassen M
authors.initials: KM
authors.lastname: Kirov
authors.forename: Marc A
authors.initials: MA
authors.lastname: Bollet
authors.forename: Nicolas
authors.initials: N
authors.lastname: Magné
authors.forename: Lionel
authors.initials: L
authors.lastname: Védrine
authors.forename: Serge
authors.initials: S
authors.lastname: Cremades
authors.forename: Philippe
authors.initials: P
authors.lastname: Beuzeboc
authors.forename: Alain
authors.initials: A
authors.lastname: Fourquet
authors.forename: Youlia M
authors.initials: YM
authors.lastname: Kirova
mesh_terms: D001943:Breast Neoplasms / Q000628:therapy*; D003131:Combined Modality Therapy / Q000009:adverse effects; D005260:Female; D014943:Global Health; D006331:Heart Diseases / Q000453:epidemiology / Q000209:etiology*; D006801:Humans; D015994:Incidence; D018570:Risk Assessment; D012307:Risk Factors