Would you give anthracycline chemotherapy to a patient with HR+, HER2 negative inflammatory breast cancer who has history of cardiomyopathy with LVH and moderately reduced EF but most recent echo shows improvement to normal or near normal ejection fraction?  

This is a tricky one. The main question is not what the current LVEF is, in my opinion. While it is reassuring to have a normal EF, comorbidities and/or prior cardiac disease is where the permanent damage of anthracyclines come into picture. Therefore, how safely can we give anthracycline based regi...

Tailoring chemotherapy to patient comorbidities remains challenging especially when efficacy may be compromised. We weigh the risks and benefits of anthracycline in conjunction with the cardio oncologist in such benefit and maximize cardiac function at our institution. To buy time, you can flip the ...

There is considerable variability in cardiac tolerance of Doxorubicin. Whereas the cumulative dose limit is 450 mg/m2 (it used to be 550 mg/m2) when the drug was first marketed in the 1970s. Epirubicin is less cardiotoxic and has been widely used in Europe in the FEC or EC regimens. However, the saf...

This patient has inflammatory BC which pushes me to strongly consider an anthracycline. I am assuming consultation with cardio-oncology, afterload reduction, and probably after discussion to follow the patient with MRI to look at strain. You have not provided the age of the patient or co-morbidities...

I have had a similar patient, I ended up consulting cardiology and after discussion with the patient, gave her AC x4 with dexrazoxane and taxol weekly x12. She had an excellent response. We did have some cytopenia related delay in one of the AC cycles as expected but otherwise was ok.