Moderate-severe (n = 15) | Mild (n = 27) | Minimal (n = 72) | P value | |
---|---|---|---|---|
Clinical characteristics | ||||
Age | 55.7 ± 12.4 | 59.0 ± 9.6 | 55.9 ± 10.6 | 0.39 |
Post-menopausal | 9 (60%) | 22 (81%) | 50 (69%) | 0.40 |
Hypertension | 4 (27%) | 10 (37%) | 25 (35%) | 0.79 |
Diabetes | 1 (7%) | 2 (7%) | 12 (17%) | 0.42 |
Hyperlipidemia | 1 (7%) | 3 (11%) | 9 (13%) | 1.00 |
Cigarette smoking (current) | 2 (13%) | 8 (30%) | 10 (14%) | 0.19 |
Congestive heart failure | 0 | 0 | 1 (1%) | 1.00 |
Valve disease | 0 | 0 | 1 (1%) | 1.00 |
Arrhythmia | 0 | 0 | 2 (3%) | 1.00 |
Coronary artery disease | 0 | 1 (4%) | 1 (1%) | 0.60 |
Stroke | 0 | 0 | 0 | N/A |
HF symptoms with LVEF decline | 8 (53%) | 4(15%) | 15 (21%) | 0.01 |
Cancer characteristics | ||||
Left-sided cancer | 9 (60%) | 14 (52%) | 39 (54%) | 0.10 |
Lymph node involvement | 7 (47%) | 14 (52%) | 37 (51%) | 0.94 |
Treatment characteristics | ||||
Mastectomy | 11 (73%) | 24 (89%) | 61 (85%) | 0.42 |
Radiation | 13 (87%) | 21 (78%) | 53 (74%) | 0.55 |
Radiation dose (Gy) | 55 (42.5,90) | 80 (40,98.4) | 53.75 (0,87.25) | 0.45 |
Anthracycline | 15 (100%) | 25 (93%) | 61 (85%) | 0.23 |
Cumulative dose (mg/m2) | 240 (240,240) | 240 (150,240) | 240 (150,240) | 0.04 |
Trastuzumab cycles received | 7 (4,11) | 14 (10,17) | 16 (10,17) | 0.002 |
Trastuzumab interruption | 15 (100%) | 27 (100%) | 67 (93%) | 0.10 |
Trastuzumab re-started | 6 (40%) | 16 (59%) | 43 (60%) | 0.36 |
Completed planned trastuzumab | 1 (7%) | 10 (37%) | 35 (49%) | 0.01 |
Other management | ||||
Cardiology referral | 14 (93%) | 21 (78%) | 40 (56%) | 0.006 |
Beta blocker | 15 (100%) | 14 (52%) | 28 (39%) | < 0.0001 |
ACE inhibitor | 15 (100%) | 18 (67%) | 38 (53%) | 0.002 |
Loop diuretic | 9 (60%) | 7 (26%) | 8 (11%) | 0.0001 |
Mineralocorticoid receptor antagonist | 9 (60%) | 1 (4%) | 1 (1%) | < 0.0001 |
Outcomes | ||||
Breast cancer recurrence | 3 (20%) | 5 (19%) | 12 (17%) | 0.88 |
All cause mortality | 1 (7%) | 4 (15%) | 6 (8%) | 0.64 |