Abstract:

Objective

To investigate the incidence of heart valve regurgitation in patients with HER-2 positive breast cancer after trastuzumab administration.

Methods

A retrospective study was conducted on 338 HER-2 positive breast cancer patients treated with trastuzumab from November 2010 to November 2014. The occurrence of heart valve regurgitation was analyzed after trastuzumab administration. The color Doppler ultrasound of the heart was used to observe the occurrence of heart valve regurgitation before and after trastuzumab treatment.

Results

All patients were followed up for 8.0-54.0 months, median 12.0 months.Among all 338 patients, heart valve regurgitation occurred in 25 patients after trastuzumab treatment, with the incidence of 7.4%. Among those 25 patients,11 (44%) had simple mitral regurgitation,2 (8%) had simple tricuspid regurgitation, 1 (4%) had simple aortic regurgitation, 1 (4%) had simple pulmonary artery regurgitation,6 cases (24%) had mitral and tricuspid regurgitation, 1 case (4%) had mitral regurgitation combined with pulmonary valve regurgitation, and 3 cases (12%) had regurgitation in mitral, tricuspid and pulmonary valves. The left ventricular ejection fraction (LVEF) in 25 patients was (72.2±6.5)% before trastuzumab treatment and (70.6±6.0)% in the first valve regurgitation. For all 20 patients with mitral regurgitation, the left ventricular diameter and the left atrial diameter was (44.2±2.8) mm and (27.0 ± 2.9)mm before trastuzumab treatment, (45.1±4.5) mm and (27.4±2.7) mm in the first valve regurgitation. The total recovery rate of heart valve regurgitation during follow-up was 36% (9/25).

Conclusion

HER-2 positive breast cancer patients are in risk of heart valve regurgitation after trastuzumab treatment and most of the complications are mitral and tricuspid regurgitations.

Key words: Breast neoplasms, Drug toxicity, Heart valve diseases