Introduction:

Cardiac dysfunction emerges as one of the main causes of morbidity and mortality among cancer survivors. Currently, trastuzumab is considered part of the standard therapy for breast cancer; however, it is associated with a varied incidence of cardiotoxicity.

Clinical case report:

A case of a 52-year-old female patient is reported here, because she received neoadjuvant therapy with anthracyclines and later, taxanes combined with trastuzumab. She underwent a quadrantectomy of her left breast for an infiltrating lobular duct carcinoma, stage IIIa, with a phenotype: luminal B-Her2 positive. She developed congestive heart failure after two doses of postoperative trastuzumab. The left ventricular ejection fraction decreased from 65% (prior to anthracycline treatment) to 44%. She was treated with enalapril, carvedilol, and spironolactone. The left ventricular ejection fraction was recovered to 57%, so trastuzumab was reintroduced and thus complete the 18 planned doses, after four months of suspension. Currently, she is disease-free, on hormonal treatment with letrozole, and without cardiovascular symptoms.

Conclusions:

Cardiotoxicity due to trastuzumab can be reversible, if it is appropriately and timely treated, within the framework of multidisciplinary groups and Cardio-Oncology Units.

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