Effects of four cycles of anthracycline based chemotherapy on cardiac ejection fraction in breast cancer patients.

Objective: To assess the impact of four cycles of anthracycline chemotherapy on left ventricle ejection fraction in breast cancer patients. Study Design: Analytical Observational, Cohort study. Setting: Department of Oncology, Jinnah Postgraduate Medical Center, Karachi, Pakistan. Period: July 2023 to August 2024. Methods: A total of 56 patients with histologically confirmed BC cases of any age group were analyzed. A sample size of 56 was determined using OPENEPI, with a 95% confidence interval and 80% power. Data were collected through a predefined proforma, covering demographic information, breast cancer details, echocardiography findings (specifically left ventricular ejection fraction [LVEF]), and doxorubicin side effects. Treatment involved use of doxorubicin with LVEF measured at baseline and after four cycles of drug. Results: In a total of 56 patients, the mean age was 47.07±11.69 years. The baseline LVEF was 62.86±2.77%, which decreased to 60.50±5.32% after four treatment cycles. Comorbid conditions like hypertension, and a combination of hypertension and diabetes were noted in 32.1%, and 10.7% patients, respectively. All four drug cycles were administered to 92.9% of patients, with 14.3% requiring treatment discontinuation due to adverse events. Conclusion: Patients with elevated baseline LVEF levels tend to sustain higher LVEF levels after undergoing chemotherapy. These results emphasize the significance of vigilant LVEF monitoring in breast cancer patients treated with anthracycline chemotherapy, to enhance the management of potential cardiotoxicity.