It may be that monitoring drops off after baseline because cardiotoxicity tends to manifest within the first 3 months of chemotherapy.

It’s unclear why these guidelines aren’t being met, the investigators acknowledge.

As such, the National Comprehensive Cancer Network recommends that women given trastuzumab undergo echocardiography or radionuclide ventriculography prior to their regimen and then at every 3 months during treatment. Trastuzumab (Herceptin) in particular, the “cornerstone of systemic therapy for patients with HER2-positive tumors,” is linked to cardiotoxicity in about 4 to 10% of women, they note. Theirs is the first study, they say, to study patterns in cardiotoxicity and cardiac monitoring to such a degree across a population that includes both younger and older women. Henry, BS (The University of Texas MD Anderson Cancer Center, Houston), and colleagues point out. Younger women are less vulnerable, due to having fewer comorbidities on the whole, but they also tend to live longer and get more aggressive chemotherapy, lead author Mariana L. Fewer than half of all women with breast cancer treated with chemotherapy are followed up with the recommended cardiac monitoring to help identify left ventricular dysfunction, according to a new, 5-year study.

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