Current Breast Cancer Reports

, Volume 9, Issue 3, pp 173–182 | Cite as

Incidence, Diagnosis, and Treatment of Cardiac Toxicity From Trastuzumab in Patients With Breast Cancer

  • Somaira Nowsheen
  • Paul V Viscuse
  • Ciara C. O’Sullivan
  • Nicole P. Sandhu
  • Tufia C. Haddad
  • Anne Blaes
  • Jennifer Klemp
  • Lara Nhola
  • Joerg Herrmann
  • Kathryn J. Ruddy
Clinical Trials (PF Peddi, Section Editor)
Part of the following topical collections:
  1. Topical Collection on Clinical Trials


Purpose of Review

Treatment with trastuzumab is a cornerstone of human epidermal growth factor receptor 2 (HER2)-overexpressing breast cancer treatment, but carries an unfortunate risk of toxicity to the cardiovascular system. Here, we review recent findings on trastuzumab-associated cardiotoxicity, focusing on its incidence, diagnosis, and treatment.

Recent Findings

Screening with multigated acquisition scan (MUGA) or echocardiogram (ECHO) is recommended to assess cardiac function prior to and during trastuzumab therapy. Because trastuzumab-induced cardiotoxicity is typically reversible, cessation of trastuzumab and/or administration of first-line heart failure agents effectively restores cardiac function in most cases. Severe trastuzumab-induced cardiotoxicity is rare enough that the risk-benefit ratio still weighs in favor of its use in the vast majority of patients with HER2+ breast cancer.


An improved understanding of the pathophysiology underlying trastuzumab-induced cardiotoxicity and the identification of patients at highest risk will allow us to continue to safely administer trastuzumab in patients with breast cancer.


Breast cancer Trastuzumab Cardiotoxicity Cardiomyopathy HER2 Cardio-oncology 


Compliance With Ethical Standards

Conflict of Interest

The authors declare that they have no competing interests.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.

Source of Funding

K.J.R. was supported by a training grant under the CTSA Grant Program Numbers UL1 TR000135 and KL2TR000136-09 from the National Center for Advancing Translational Sciences (NCATS) of the NIH. The contents of this paper are solely the responsibility of the authors and do not necessarily represent the official view of NIH.


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Copyright information

© Springer Science+Business Media, LLC 2017

Authors and Affiliations

  • Somaira Nowsheen
    • 1
  • Paul V Viscuse
    • 2
  • Ciara C. O’Sullivan
    • 3
  • Nicole P. Sandhu
    • 4
  • Tufia C. Haddad
    • 3
  • Anne Blaes
    • 5
  • Jennifer Klemp
    • 6
  • Lara Nhola
    • 7
  • Joerg Herrmann
    • 8
  • Kathryn J. Ruddy
    • 3
  1. 1.Mayo Clinic Graduate School of Biomedical SciencesMayo Clinic School of Medicine and the Mayo Clinic Medical Scientist Training ProgramRochesterUSA
  2. 2.Department of MedicineMayo ClinicRochesterUSA
  3. 3.Division of Medical OncologyMayo ClinicRochesterUSA
  4. 4.Division of General Internal MedicineMayo ClinicRochesterUSA
  5. 5.Department of MedicineUniversity of MinnesotaRochesterUSA
  6. 6.Division of Clinical OncologyUniversity of Kansas Medical CenterWichitaUSA
  7. 7.Division of Cardiology ResearchMayo ClinicRochesterUSA
  8. 8.Department of Cardiovascular DiseasesMayo ClinicRochesterUSA

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