Prolonged impact of anti-cancer therapy on endothelial function and arterial stiffness in breast cancer patients

Background: Cardiotoxicity restricts anthracycline and trastuzumab treatment of Human Epidermal Growth Factor Receptor 2 positive early breast cancer. Endothelial dysfunction and arteriosclerosis are significant cardiovascular risk factors.Objectives: We studied the effect of anthracycline-based chemotherapy, with or without trastuzumab, on endothelium and arteriosclerosis in patients with breast cancer.Methods: In this case-control study, 52 women with breast cancer and 104 women without breast cancer were examined longitudinally up to 15 months following (in the breast cancer group) initiation of chemotherapy. Arterial stiffness was evaluated through pulse wave velocity (PWV), while endothelial function via flowmediated dilatation (FMD) at baseline (T0), 3 (T1), 6 (T2), and 15 (T3) months later.Results: There was no difference between subjects with breast cancer and control in PWV and FMD at baseline. Longitudinally, participants with breast cancer exhibited considerable impairment of PWV and FMD compared to the control group (p for interaction <0.001 for both parameters). In breast cancer patients, there was a significant increase from T0 to T3 in PWV (7.43 & PLUSMN; 1.68 m/s vs. 8.18 & PLUSMN; 2.00 m/s, p = 0.01) and decrease in FMD (6.95 & PLUSMN; 2.86% vs. 5.03 & PLUSMN; 2.83%, p = 0.006). The addition of trastuzumab in the treatment did not have any effect on PWV (p = 0.74) or FMD (p = 0.91).Conclusions: In patients with breast cancer, there is progression of endothelial dysfunction and arteriosclerosis up to 15 months following initiation of anthracycline-based chemotherapy. Trastuzumab has no additive effect on endothelial function or arterial stiffness.

Automated summary

This study examined the impact of anthracycline-based chemotherapy, with or without trastuzumab, on endothelial function and arteriosclerosis in breast cancer patients. The results showed that there was a significant deterioration in endothelial function and arterial stiffness up to 15 months after chemotherapy initiation in breast cancer patients, and trastuzumab had no significant effect on these parameters.