Arterial Stiffness Changes Following Chemotherapy in Patients with Breast Cancer: A Prospective Observational Study

Abstract Systemic chemotherapy is an important component of breast cancer treatment but may be associated with cardiovascular toxicity. Arterial stiffness, assessed by central pulse wave velocity (cPWV), is a marker of vascular aging and cardiovascular risk. This study evaluated changes in cPWV following systemic chemotherapy in women with breast cancer. This prospective observational cohort study included 111 women with histologically confirmed breast cancer who completed planned systemic chemotherapy. cPWV was measured before chemotherapy and after treatment completion. Demographic, clinical, tumor-related, and treatment-related variables were collected. The primary outcome was the change in cPWV after chemotherapy. Paired tests and multivariable linear regression were used for analysis. Mean cPWV increased significantly from 6.55 ± 0.94 m/s at baseline to 7.58 ± 1.52 m/s after chemotherapy (p < 0.001). The mean ΔcPWV was 1.02 ± 0.82 m/s, and 84.7% of patients showed increased cPWV. No significant differences in ΔcPWV were observed among chemotherapy regimens or drug-class exposures. In obese patients, cPWV increased numerically but not significantly. In multivariable analysis, age, baseline cPWV, and hypertension were independently associated with ΔcPWV. Systemic chemotherapy was associated with a significant increase in arterial stiffness in women with breast cancer, as demonstrated by changes in cPWV after treatment. These findings suggest that chemotherapy may be accompanied by measurable vascular alterations in addition to previously recognized cardiac effects.