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Cardiology Research and Practice
Volume 2012, Article ID 135819, 5 pages
Clinical Study

The Experience of a Multidisciplinary Clinic in the Management of Early-Stage Breast Cancer Patients Receiving Trastuzumab Therapy: An Observational Study

1Division of Medical Oncology, Department of Medicine, University of Ottawa, The Ottawa Hospital Cancer Centre, Ottawa, ON, Canada K1H 8L6
2Department of Pharmacy, The Ottawa Hospital Cancer Centre, Ottawa, ON, Canada K1H 8L6
3The Ottawa Hospital Cancer Centre, Ottawa, ON, Canada K1H 8L6
4Division of Cardiology, Department of Medicine, University of Ottawa, The Ottawa Hospital, Ottawa, ON, Canada K1H 8L6

Received 14 May 2012; Revised 24 July 2012; Accepted 25 July 2012

Academic Editor: Syed Wamique Yusuf

Copyright © 2012 Susan Dent et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Background. We established a dedicated cardiac oncology clinic in 2008 for the rapid diagnosis and treatment of cardiotoxicity related to cancer therapy. In this retrospective observational study, we report on clinical outcomes in women with early-stage breast cancer (EBC) referred to this clinic. Methods. Patients with EBC treated with chemotherapy/trastuzumab and referred between October 2008 and December 2010. Data included patient demographics, staging, cancer treatment/completion, dose delays, left ventricular ejection fraction (LVEF) and cardiac treatment. Results. Forty eight patients: median age 55.5 years, stage I/II disease (77%) and HER-2 positive (98%). The majority of women ( ) were referred for decreases in LVEF (from baseline). Overall, 37 (77%) patients experienced at least one drop in LVEF while on treatment, of which 22 patients (59%) experienced a ≥10 percentage point drop. The majority of patients (30/37; 81%) experienced declines in LVEF while on trastuzumab. Interventions included trastuzumab delays ( /48; 33%) and cardiac medication (12/48: 25%). A total of 81% of patients completed ≥90% of trastuzumab therapy and 15% of patients discontinued therapy due to cardiotoxicity. Conclusion. The majority of patients referred to our clinic completed therapy. Further studies are needed to determine the impact of this multidisciplinary approach on treatment completion and cardiac outcomes.