Trial Finds Many Breast Cancer Survivors Can Safely Stop Lifelong Heart Medication

Many breast cancer survivors whose cancer treatment damaged their heart function can safely stop taking heart medication once their heart recovers, according to a trial presented at the European Society of Cardiology Congress in Munich and published in the European Heart Journal.

The trial involved 90 women, most in their 40s and 50s, who had recovered from heart problems caused by HER2-targeted breast cancer treatment such as trastuzumab, sold as Herceptin. Around 10% of patients on such treatment develop heart function problems requiring drugs including beta-blockers and ACE inhibitors, and patients are currently advised to stay on them for life. Researchers randomly assigned 46 women to gradually withdraw from their heart failure medication and 44 to continue taking it, following both groups for a year with blood tests, quality-of-life questionnaires and cardiac MRI scans.

After one year, 98% of the women who stopped their medication showed no decline in heart function. Only one woman, whose decline was picked up on an MRI scan without any symptoms, saw her heart function improve again after restarting medication. Left ventricular ejection fraction, a measure of the heart's pumping ability, remained similar in both groups: 55.2% in the withdrawal group compared with 55.6% in the group that continued treatment. Women who stopped their medication also reported slightly better quality of life at 12 months.

The trial was led by Professor Charlotte Manisty of University College London and Barts Heart Centre. Breast cancer is the most common cancer in the UK, with nearly 60,000 new cases diagnosed each year, and 15% to 20% of cases are HER2-positive.