Most breast cancer survivors whose treatment causes heart damage may not need lifelong medication, according to a British Heart Foundation-funded study published in the Heart Journal and led by Professor Charlotte Manisty, head of clinical cardiovascular science at University College London. Researchers found that 98 per cent of trial participants who stopped taking precautionary heart drugs experienced no decline in heart function after one year, with just one woman developing a problem with her heart’s pumping ability.
Modern breast cancer therapies save lives, but certain treatments can weaken heart muscle over time. For years, patients whose scans revealed declining heart function during cancer care faced a daunting prospect: staying on protective heart medications for the rest of their lives to prevent further decline, as some therapies can weaken the heart and medication is then needed to protect it.
Inside the British Heart Foundation Trial
The new study involved 90 women in their 40s and 50s across four UK hospitals whose hearts had recovered after a specific treatment for breast cancer. Most would have been advised to stay on heart drugs for life over concerns heart function would decline if they stopped. Led by Professor Charlotte Manisty, head of clinical cardiovascular science at University College London, the trial sought to determine whether precautionary drugs could be safely withdrawn.
Our study provides the first evidence that heart failure therapies can be safely stopped in survivors whose hearts have recovered, with the support of close monitoring.
Only one woman in the group developed a problem with her heart’s pumping ability, while 98 per cent of patients in the group who stopped taking medication had no change in heart function after one year.
Patient Experiences and Quality of Life
Beyond physiological measures, women who came off drugs also reported, in questionnaires, a better quality of life. For patients like Lucy Shepherd, from Hertfordshire, the trial lifted a heavy psychological burden.
Lucy Shepherd was diagnosed with triple positive breast cancer shortly after her 33rd birthday, but a routine scan revealed that her heart function had declined during care. She was put on medication before starting another round of treatment.
Being part of the trial and having the chance to come off my heart medication has definitely improved my life.
Lucy Shepherd, trial participant
Now 39, Ms Shepherd said that living beyond her cancer treatment was difficult because no one could tell her whether she should stop or continue taking heart medication. She added that she is still taking hormone therapy but does not live with the fear she once had, noting that taking part in the trial left her feeling strong, knowing she can take on new challenges and helping her to trust her body again.
Next Steps and Long-Term Monitoring
Medical experts emphasize that while the initial findings are described as hugely encouraging
for patients and thousands of survivors whose heart health has been damaged by life-saving treatment, careful supervision remains essential. Dr Sonya Babu-Narayan of the British Heart Foundation noted that the study results give hope that many women will be able to safely stop taking medicines once their heart has recovered, adding that more research is needed.
The women in the trial will be followed up over the next five years to monitor their heart health. Researchers hope the extended follow-up will provide definitive guidance for clinicians helping patients navigate life after cancer treatment, giving hope for a future free from treatment.
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