Severe aortic stenosis in a patient with breast cancer Case report
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Published:
Apr 5, 2016
Keywords:
aortic stenosis, breast cancer, anthracyclines, aortic valve replacment, echocardiography
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Abstract
We present a case of 68-year-old female with severe symptomatic aortic stenosis and locally advanced breast cancer disqualified from mastectomy due to heart failure and from aortic valve replacement due to malignant neoplasm. The patient received neoadjuvant chemotherapy without anthracyclines. The aortic valve replacement was performed and then mastectomy and lymphadenectomy were made without hemodynamic complications. Adjuvant hormonotherapy was started. During 42 months of follow-up the patient remained free of recurrent cancer disease as well as no progression of heart failure was observed.
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Mańczak R, Wilk M, Walaszkowska-Czyż A, Florczyk M, Szmit S. Severe aortic stenosis in a patient with breast cancer. OncoReview [Internet]. 2016Apr.5 [cited 2024May4];6(2(22):49-6. Available from: https://journalsmededu.pl/index.php/OncoReview/article/view/477
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Copyright: © Medical Education sp. z o.o. This is an Open Access article distributed under the terms of the Attribution-NonCommercial 4.0 International (CC BY-NC 4.0). License (https://creativecommons.org/licenses/by-nc/4.0/), allowing third parties to copy and redistribute the material in any medium or format and to remix, transform, and build upon the material, provided the original work is properly cited and states its license.
Address reprint requests to: Medical Education, Marcin Kuźma (marcin.kuzma@mededu.pl)
References
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24. Peto R, Davies C, Godwin J et al. Comparisons between different polychemotherapy regimens for early breast cancer: meta-analyses of long-term outcome among 100,000 women in 123 randomised trials. Lancet 2012; 379: 432-444.
25. Opolski G, Krzakowski M, Szmit S et al. Task Force of National Consultants in Cardiology and Clinical Oncology [Recommendations of National Team of Cardiologic and Oncologic Supervision on cardiologic safety of patients with breast cancer. The prevention and treatment of cardiovascular complications in breast cancer. The Task Force of National Consultants in Cardiology and Clinical Oncology for the elaboration of recommendations of cardiologic proceeding with patients with breast cancer]. Kardiol Pol 2011; 69(5): 520-530.
26. Hart CD, Sama G, Sidari O. Defining optimal duration and predicting benefit from chemotherapy in patients with luminal-like subtypes. Breast 2015; 24(suppl 2): S136-142.
27. Jones S, Holmes FA, O’Shaughnessy J et al. Docetaxel With Cyclophosphamide Is Associated With an Overall Survival Benefit Compared With Doxorubicin and Cyclophosphamide: 7-Year Follow-Up of US Oncology Research Trial 9735. J Clin Oncol 2009; 27(8): 1177-1183.
28. Kawecka-Jaszcz K, Bednarek PA. The management of cancer patients with heart disease. Przegl Lek 2012; 69(2): 82-86.
29. Stachowiak P, Kornacewicz-Jach Z, Safranow K. Prognostic role of troponin and natriuretic peptides as biomarkers for deterioration of left ventricular ejection fraction after chemotherapy. Arch Med Sci 2014; 10(5): 1007-1018
2. Yusuf SW, Sarfaraz A, Durand JB et al. Management and outcomes of severe aortic stenosis in cancer patients. Am Heart J 2011; 161(6): 1125-1132.
3. Early Breast Cancer Trialists’ Collaborative Group. Effects of chemotherapy and hormonal therapy for early breast cancer on recurrence and 15-year survival: an overview of the randomised trials. Lancet 2005; 365: 1687-1717.
4. Steinherz LJ, Steinherz PG, Tan CT et al. Cardiac toxicity 4 to 20 years after completing anthracycline therapy. JAMA 1991; 266(12): 1672-1677.
5. Rossi S, Baili P, Capocaccia R et al; EUROCARE-5 Working Group. The EUROCARE-5 study on cancer survival in Europe 1999-2007: database, quality checks and statistical analysis methods. Eur J Cancer 2015 Sep 6 [pii: S0959-8049(15)00776-5].
6. Otto CM. Timing of aortic valve surgery. Heart 2000; 84: 211-218.
7. Vahanian A, Alfieri O, Andreotti F et al; Joint Task Force on the Management of Valvular Heart Disease of the European Society of Cardiology (ESC); European Association for Cardio-Thoracic Surgery (EACTS). Guidelines on the management of valvular heart disease (version 2012). Eur Heart J 2012; 33(19): 2451-2496.
8. Nishimura RA, Otto CM, Bonow O et al; American College of Cardiology/American Heart Association Task Force on Practice Guidelines. 2014 AHA/ACC guideline for the management of patients with valvular heart disease: executive summary: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. J Am Coll Cardiol 2014; 63(22): 2438-2488.
9. Fleisher LA, Beckman JA, Brown KA et al. ACC/AHA 2007 guidelines on perioperative cardiovascular evaluation and care for noncardiac surgery: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Revise the 2002 Guidelines on Perioperative Cardiovascular Evaluation for Noncardiac Surgery): developed in collaboration with the American
Society of Echocardiography, American Society of Nuclear Cardiology, Heart Rhythm Society, Society of Cardiovascular Anesthesiologists, Society for Cardiovascular Angiography and Interventions, Society for Vascular Medicine and Biology, and Society for Vascular Surgery. Circulation 2007; 116(17): e418-e499.
10. Freeman WK, Gibbons RJ. Perioperative cardiovascular assessment of patients undergoing noncardiac surgery. Mayo Clin Proc 2009; 84(1): 79-90.
11. Lee TH, Mangione CM. Derivation and prospective validation of a simple index for prediction of cardiac risk of major noncardiac surgery. Circulation 1999; 100: 1043-1049.
12. Goldman L, Caldera DL, Nussbaum SR et al. Multifactorial index of cardiac risk in noncardiac surgical procedures. N Engl J Med 1977; 297: 845-850.
13. Kertai MD, Bountioukos M, Boersma E et al. Aortic stenosis: an underestimated risk factor for perioperative complications in patients undergoing noncardiac surgery. Am J Med 2004; 116(1): 8-13.
14. Torsher LC, Shub C, Rettke SR, Brown DL. Risk of patients with severe aortic stenosis undergoing noncardiac surgery. Am J Cardiol 1998; 81(4): 448-452.
15. Kauffmann M, Krüger T, Aebert H. Surgery on extracorporeal circulation in early and advanced non-small cell lung cancer. Thorac Cardiovasc Surg 2013; 61(2): 103-108.
16. Özsöyler İ, Yilik L, Bozok Ş. Off-pump coronary artery bypass surgery in patients with coronary artery disease and malign neoplasia: results of ten patients and review of the literature. Heart Vessels 2006; 21: 365-367.
17. Carrascal Y, Gualis J, Arévalo A et al. Cardiac surgery with extracorporeal circulation in cancer patients: influence on surgical morbidity and mortality. Rev Esp Cardiol 2008; 61(4): 369-375.
18. Canver CC, Marrin CA, Plume ST, Nugent WC. Should a patient with a treated cancer be offered an open heart operation? Ann Thorac Surg 1993; 55: 1202-1204.
19. Schoenmakers MC, van Boven WJ, van den Bosch J, Swieten HA. Comparison of on-pump or off-pump coronary artery revascularization with lung resection. Ann Thorac Surg 2017; 84: 504-509.
20. Roques F, Nashef SAM, Michel P et al. Risk factors and outcome in European cardiac surgery: analysis of the EuroSCORE multinational database of 19030 patients. Eur J Cardiothorac Surg 1999; 15: 816-823.
21. Nashef SAM, Roques F, Sharples L et al. EuroSCORE II. Eur J Cardiothorac Surg 2012; 41: 1-12.
22. Nikitovic D, Juranek I, Wilks MF et al. Anthracycline-dependent cardiotoxicity and extracellular matrix remodeling. Chest 2014; 146(4): 1123-1130.
23. Szmit S, Streb J, Starzec W et al. Left ventricular systolic dysfunction in metastatic breast cancer patients: a Polish multicenter registry. Anticancer Res 2015; 35(2): 989-995.
24. Peto R, Davies C, Godwin J et al. Comparisons between different polychemotherapy regimens for early breast cancer: meta-analyses of long-term outcome among 100,000 women in 123 randomised trials. Lancet 2012; 379: 432-444.
25. Opolski G, Krzakowski M, Szmit S et al. Task Force of National Consultants in Cardiology and Clinical Oncology [Recommendations of National Team of Cardiologic and Oncologic Supervision on cardiologic safety of patients with breast cancer. The prevention and treatment of cardiovascular complications in breast cancer. The Task Force of National Consultants in Cardiology and Clinical Oncology for the elaboration of recommendations of cardiologic proceeding with patients with breast cancer]. Kardiol Pol 2011; 69(5): 520-530.
26. Hart CD, Sama G, Sidari O. Defining optimal duration and predicting benefit from chemotherapy in patients with luminal-like subtypes. Breast 2015; 24(suppl 2): S136-142.
27. Jones S, Holmes FA, O’Shaughnessy J et al. Docetaxel With Cyclophosphamide Is Associated With an Overall Survival Benefit Compared With Doxorubicin and Cyclophosphamide: 7-Year Follow-Up of US Oncology Research Trial 9735. J Clin Oncol 2009; 27(8): 1177-1183.
28. Kawecka-Jaszcz K, Bednarek PA. The management of cancer patients with heart disease. Przegl Lek 2012; 69(2): 82-86.
29. Stachowiak P, Kornacewicz-Jach Z, Safranow K. Prognostic role of troponin and natriuretic peptides as biomarkers for deterioration of left ventricular ejection fraction after chemotherapy. Arch Med Sci 2014; 10(5): 1007-1018