ABSTRACT
Background: Chemotherapy remains a cornerstone in breast cancer management but is associated with significant cardiovascular toxicity, which may adversely affect long-term outcomes. Anthracyclines are particularly implicated due to their dose-dependent cardiotoxic effects.
Objective: To synthesize current evidence on chemotherapy-induced cardiotoxicity in breast cancer, with emphasis on anthracycline-related cardiac dysfunction, including epidemiology, mechanisms, risk factors, detection, and prevention.
Methods: A scoping review of peer-reviewed literature was conducted using PubMed, Scopus, Web of Science, and Google Scholar. Studies evaluating cardiovascular complications of chemotherapy in breast cancer were included.
Results: Cardiotoxicity risk is associated with cumulative anthracycline dose, concurrent use of cardiotoxic agents such as trastuzumab, and pre-existing cardiovascular disease. Mechanisms include oxidative stress, mitochondrial dysfunction, and topoisomerase II inhibition. Early detection using speckletracking echocardiography and biomarkers such as troponins and natriuretic peptides allows identification of subclinical myocardial injury. Preventive strategies—including dose modification, liposomal anthracyclines, and
cardioprotective agents such as dexrazoxane, beta-blockers, and ACE inhibitors—demonstrate benefit.5/13/2026
Conclusion: Chemotherapy-induced cardiotoxicity remains a major clinical challenge. Early detection, risk stratification, and integrated cardio-oncology care are essential to improving outcomes in breast cancer patients.
Keywords: Breast cancer; Anthracyclines; Cardiotoxicity; Chemotherapy; Cardio-oncology