%0 Journal Article
%T That an Ounce of Prevention Is Worth a Pound of Cure Is Certainly True for Patients With Breast Cancer
%A Daniel J. Lenihan
%J General Information | Journal of Oncology Practice
%D 2018
%R https://doi.org/10.1200/JOP.18.00155
%X The review by Ky,1 a recognized true expert in the field, emphasizes the importance of assessing cardiovascular disease in patients who are survivors of breast cancer. As stated by Ky, there are common clinical risk factors that make patients susceptible to breast cancer and cardiac disease, but there also are important cancer treatment-related risks that must be considered that are unique to patients who have developed breast cancer. The review highlights the need for a collaborative approach to optimize the treatment of these patients. By detailing the cardiovascular impact of anthracycline-based treatment, human epidermal growth factor receptor 2 targeted therapy, radiation, and hormonal therapy, Ky demonstrates that a multidisciplinary approach with actively engaged cardiologists, primary care providers, exercise physiologists, and oncologists is not only ideal but imperative. Not included in the review by Ky is the newly established, important breast cancer therapy of cyclin-dependent kinase 4/6 inhibitors and the potential for important electrocardiographic changes during initiation with one of these agents, ribociclib. How this promising treatment can be safely administered remains to be defined. Furthermore, Ky discusses the contemporary use of cardiac-based biomarkers and imaging, which is certainly an area of intense interest in the field, with active clinical trials intended to define the best approach. Lastly, Ky describes cardioprotective strategies that are under development in clinical practice at this time. I acknowledge that the clinical science in this area remains in its infancy, but I feel that this area is our collective frontier that we should strive to develop aggressively. For example, there is emerging evidence of a cardioprotective effect for statins, selected ¦Â-blocker medications, certain renin-angiotensin inhibitors, and exercise. It seems to make the most sense to prevent the development of cardiac dysfunction, rather that attempting to manage it when it occurs. The review by Ky highlights many of these important issues and, I hope, can help to stimulate a team approach to the treatment of all of our patients.Copyright £¿ 2018 by American Society of Clinical Oncology AUTHOR¡¯S DISCLOSURES OF POTENTIAL CONFLICTS OF INTEREST That an Ounce of Prevention Is Worth a Pound of Cure Is Certainly True for Patients With Breast Cancer The following represents disclosure information provided by authors of this manuscript. All relationships are considered compensated. Relationships are self-held unless noted. I = Immediate Family Member,
%U http://ascopubs.org/doi/full/10.1200/JOP.18.00155