Anthracycline and Trastuzumab-Based Therapy in Early Stage Breast Cancer: Do the Data Justify Cardiac Surveillance?

Anthracycline-based and trastuzumab-containing regimens make a significant impact on reducing the risk of distant metastases and improving cause-specific and overall survival in early stage breast cancer. However, these regimens may cause cardiomyopathy during and after treatment. Despite anthracyclines being in use for nearly fifty years, there are no evidence-based guidelines for cardiac surveillance in asymptomatic breast cancer survivors. In fact, the current guidelines for cardiac monitoring while on trastuzumab therapy were from clinical trials, with empiricism and not data informing the recommendations for cardiac monitoring.