title: [Towards an integrated approach to cardiovascular toxicities related to the treatments of breast cancer].
abstract: There is an increasing number of therapeutic options in breast cancer management. While prognosis improves, the cardiac toxicity related to treatments remains a significant issue. This toxicity has several clinical presentations and can be explained by complex and diverse molecular mechanisms. Systemic treatments (anthracyclines, inhibitors of HER2 signaling pathway, hormone therapy, antiangiogenic agents) and radiotherapy have their own cardiac toxicity. However, the toxicities associated with these treatments may potentiate together and the existence of pre-existing cardiovascular risk factors should be taken into account. The assessment of cardiac hazard evolves toward a multifactorial approach. Several possibilities exist to minimize the incidence of cardiac complications. Those include pharmacological and technological innovations, but also a more accurate selection of patients and a growing involvement of practitioners in the field of cardiac toxicity, which is prerequisite for an early management of cardiac events.
authors.affiliation: HIA du Val-de-Grâce, Service d'oncologie radiothérapie, 74, boulevard de Port-Royal, 75005 Paris, France.
authors.forename: Rachid
authors.initials: R
authors.lastname: Tanz
authors.affiliation: Institut de Cancérologie Lucien Neuwirth, Département de radiothérapie, Saint-Priest-en-Jarez, France.
authors.forename: Nicolas
authors.initials: N
authors.lastname: Magne
authors.affiliation: HIA du Val-de-Grâce, Service d'oncologie radiothérapie, 74, boulevard de Port-Royal, 75005 Paris, France.
authors.forename: Pierre
authors.initials: P
authors.lastname: Annede
authors.affiliation: Institut de Cancérologie Lucien Neuwirth, Département de radiothérapie, Saint-Priest-en-Jarez, France.
authors.forename: Benoite
authors.initials: B
authors.lastname: Mery
authors.affiliation: HIA du Val-de-Grâce, Service d'oncologie radiothérapie, 74, boulevard de Port-Royal, 75005 Paris, France.
authors.forename: Julian
authors.initials: J
authors.lastname: Jacob
authors.affiliation: HIA du Val-de-Grâce, Service d'oncologie radiothérapie, 74, boulevard de Port-Royal, 75005 Paris, France.
authors.forename: Olivier
authors.initials: O
authors.lastname: Bauduceau
authors.affiliation: Institut de Cancérologie Lucien Neuwirth, Département de radiothérapie, Saint-Priest-en-Jarez, France.
authors.forename: Jane-Chloé
authors.initials: JC
authors.lastname: Trone
authors.affiliation: Institut de Cancérologie Lucien Neuwirth, Département de radiothérapie, Saint-Priest-en-Jarez, France.
authors.forename: Jean-Baptiste
authors.initials: JB
authors.lastname: Guichard
authors.affiliation: HIA du Val-de-Grâce, Service d'oncologie radiothérapie, 74, boulevard de Port-Royal, 75005 Paris, France.
authors.forename: Nicolas
authors.initials: N
authors.lastname: Meillan
authors.affiliation: Institut Curie, Département de radiothérapie, Paris, France.
authors.forename: Youlia
authors.initials: Y
authors.lastname: Kirova
authors.affiliation: HIA du Val-de-Grâce, Service d'oncologie radiothérapie, 74, boulevard de Port-Royal, 75005 Paris, France.
authors.forename: Lionel
authors.initials: L
authors.lastname: Vedrine
authors.affiliation: HIA du Val-de-Grâce, Service d'oncologie radiothérapie, 74, boulevard de Port-Royal, 75005 Paris, France.
authors.forename: Cyrus
authors.initials: C
authors.lastname: Chargari
mesh_terms: D000080044:Ado-Trastuzumab Emtansine; D020533:Angiogenesis Inhibitors / Q000009:adverse effects*; D018943:Anthracyclines / Q000009:adverse effects*; D061067:Antibodies, Monoclonal, Humanized / Q000009:adverse effects; D000970:Antineoplastic Agents / Q000009:adverse effects*; D018931:Antineoplastic Agents, Hormonal / Q000009:adverse effects; D000068258:Bevacizumab; D001943:Breast Neoplasms / Q000628:therapy*; D005260:Female; D006321:Heart / Q000187:drug effects* / Q000528:radiation effects*; D006331:Heart Diseases / Q000209:etiology / Q000517:prevention & control*; D006801:Humans; D000077341:Lapatinib; D015182:Lymphatic Irradiation / Q000009:adverse effects; D008453:Maytansine / Q000009:adverse effects / Q000031:analogs & derivatives; D011799:Quinazolines / Q000009:adverse effects; D011832:Radiation Injuries / Q000150:complications; D018570:Risk Assessment; D012307:Risk Factors; D058570:TOR Serine-Threonine Kinases / Q000037:antagonists & inhibitors; D000068878:Trastuzumab
chemical_list: D020533:Angiogenesis Inhibitors; D018943:Anthracyclines; D061067:Antibodies, Monoclonal, Humanized; D000970:Antineoplastic Agents; D018931:Antineoplastic Agents, Hormonal; D011799:Quinazolines; D000077341:Lapatinib; D008453:Maytansine; D000068258:Bevacizumab; C546842:MTOR protein, human; D058570:TOR Serine-Threonine Kinases; C485206:pertuzumab; D000068878:Trastuzumab; D000080044:Ado-Trastuzumab Emtansine
keywords: anthracyclines; breast cancer; cardiac toxicity; radiotherapy; targeted agents