High BMI in Breast Cancer Patients Linked With Increased Cardiotoxicity During Chemotherapy

Women being treated for breast cancer who have a high BMI may be more likely to experience cardiotoxicity during chemotherapy, according to research being presented at the American College of Cardiology Latin America 2023 conference, held August 11 to 12 in San José, Costa Rica.¹

The study was conducted in Colombia, where breast cancer survival rates have significantly improved over the last few decades. However, certain factors that can increase cardiovascular side effects in patients with breast cancer undergoing chemotherapy have not been completely understood.

“Cardiotoxicity is a relatively recent concern in cancer care, and its recognition as a significant issue is still evolving,” Ivetteh Gaibor Santos, MD, lead author on the study, said in a release.¹ “In regions with limited research infrastructure and resources, there may be a lack of specific studies or initiatives addressing cardiotoxicity in the context of breast cancer treatment.”

Investigators from the Universidad Autónoma de Bucaramanga conducted a study to determine factors that can increase the likelihood of patients experiencing cardiovascular side effects. Data was gathered from an anonymized database of patients with breast cancer who began chemotherapy treatment with doxorubicin or trastuzumab between January and December 2021.

The study cohort included 67 patients with an average age of 55 years old and a mean body mass index of 26.18 kg/m². Only patients who had a baseline echocardiogram and at least 1 follow-up echocardiogram were included in the study.

Investigators found that the prevalence of cardiotoxicity was 11.94% and that a BMI of 25 and above was the only predisposing risk factor.

The researchers noted that the early detection of cardiotoxicity is vital in order for clinicians to treat it properly. In an effort to raise awareness about cardiotoxicity risks in cancer treatment, the researchers suggested several actions, including enhanced medical education on cardiotoxicity, multidisciplinary collaboration among specialties, and supporting research initiatives focused on cardiotoxicity.

“Addressing obesity in cancer patients before starting chemotherapy as well as considering the potential risk for cardiotoxicity requires a comprehensive approach,” said Gaibor Santos. “Some strategies clinicians can consider include pre-treatment assessment, lifestyle interventions and cardiovascular risk management. It is important to note that these strategies should be tailored to each patient’s specific needs and in accordance with current evidence-based guidelines.”

Reference

1. Breast Cancer Patients with Higher BMI More Likely to Experience Heart Damage During Chemotherapy. News Release. American College of Cardiology. August 2, 2023. Accessed August 9, 2023. https://www.acc.org/About-ACC/Press-Releases/2023/08/02/14/34/Breast-Cancer-Patients-with-Higher-BMI-More-Likely-to-Experience-Heart-Damage-During-Chemotherapy