Research Progress on Anthracycline-Induced Cardiotoxicity in Breast Cancer Patients

Abstract

Anthracycline chemotherapeutic agents, including doxorubicin, epirubicin, and pirarubicin, are widely utilized in the treatment of various malignancies. These agents demonstrate significant efficacy against hematological tumors (e.g., Hodgkin lymphoma, non-Hodgkin lymphoma, and pediatric leukemia) and solid tumors (e.g., ovarian cancer, breast cancer, and gastrointestinal malignancies), playing a pivotal role in breast cancer management. However, prolonged use of these agents is associated with multiple adverse effects, including allergic reactions, cardiac damage, alopecia, myelosuppression, emesis, and bladder irritation. The most severe complication is doxorubicin-induced cardiomyopathy, which compromises myocardial function, reduces left ventricular ejection fraction (LVEF), and may lead to congestive heart failure. Although anthracycline-induced cardiotoxicity is dose-dependent, it may manifest early during treatment or emerge years after therapy cessation. The precise mechanisms underlying doxorubicin-induced cardiotoxicity remain incompletely elucidated. This review synthesizes recent research on anthracycline-induced cardiotoxicity in breast cancer patients, encompassing classification, pathogenesis, and current prevention and treatment strategies, aiming to provide references for early clinical monitoring, diagnosis, and management of this condition.