Neoadjuvant Chemotherapy: Friend or Foe

Area of Science:

• Oncology
• Cardiology
• Hematology

Background:

• Neoadjuvant chemotherapy is standard for many breast cancers, influencing surgical decisions and prognosis.
• Cardiovascular complications are significant, common, and challenging side effects of chemotherapy.
• Primary systemic therapy (PST) response is key for treatment planning and outcome prediction.

Observation:

• A 71-year-old woman with Luminal B breast cancer received FEC followed by docetaxel chemotherapy.
• She developed new-onset angina with critical coronary lesions during treatment.
• Subsequently, she experienced deep vein thrombosis, complicating management.

Findings:

• Chemotherapy-induced cardiovascular events, such as angina due to coronary lesions, can occur.
• The development of deep vein thrombosis adds another layer of complexity to patient management.
• Managing concurrent breast cancer and cardiovascular complications necessitates careful, integrated treatment strategies.

Implications:

• Multidisciplinary teams are essential for navigating complex cases involving both cancer and cardiovascular disease.
• Balancing the benefits of neoadjuvant chemotherapy against its cardiovascular risks is critical.
• Integrated care models are needed to optimize treatment decisions and minimize adverse events in oncology patients with comorbidities.