Improvement of methods used in
breast cancer therapy resulted in increased treatment effectiveness and prolonged survival of patients. However, this is accompanied by increased frequency of adverse side effects, including
cardiac toxicity, which is becoming a serious problem affecting the quality of life and overall survival of
cancer patients. The risk of developing cardiovascular complications depends on the type and dose of therapeutic agent used. The highest risk of
cardiotoxicity is associated with
anthracyclines. They are used frequently in
cancer therapy due to their high efficiency but show a dose-dependent toxicity to the cardiovascular system.
Cardiotoxicity can also occur with other substances used in
breast cancer chemotherapy, as well as with
radiotherapy. Combining potentially cardiotoxic therapeutic agents, commonly used in combination
therapy, may result in escalation of toxic side effects. Mechanisms of heart damage are different for various
cardiotoxic agents, but symptoms usually involve
heart failure,
ischemic heart disease, arrhythmias,
hypertension, valvular diseases or
pericarditis and
myocarditis. The practices used to reduce the risk of cardiotoxic effects of
cancer therapy include evaluation of cardiac functions before treatment and constant monitoring during and
after treatment. Furthermore, limited doses and modifications of
anticancer agent administration patterns are employed, as well as simultaneous application of
cardioprotective agents. Understanding of cardiotoxic mechanisms of agents used in
breast cancer treatment can help to develop efficient cardioprotective substances. Because oxidative stress plays an important role in the toxicity of
cancer therapy, compounds with
antioxidant properties are a very promising target of research.