Accelerated Atherosclerosis in Early-Stage Breast Cancer Following Chemotherapy

No present guidelines exist regarding the inclusion of atherogenic cancer or chemotherapy into atherosclerotic cardiovascular disease (ASCVD) screening or imaging screening guidelines. Individual physician preference often determines screening, and this is typically symptom guided.

A 30-year-old woman with early-stage breast cancer received atherogenic chemotherapy, with no prior atherogenic risk factors. She presented with angina and dyspnea on exertion 3 years after her last round of chemotherapy. An ischemic work-up was performed, and the patient was found to have premature critical stenosis in her proximal left anterior descending artery.

Because more patients are living with cancer and survivors of atherogenic chemotherapy emerge, it is becoming more critical to improve ASCVD screening modalities.

Expert consensus for patients with early-stage cancer treated with atherogenic chemotherapy should derive either their unique ASCVD algorithm, be included into pre-existing algorithms, or have their own multimodal imaging pathway.