Complications
Commonly associated with chemotherapy regimens.
More likely with higher doses of anthracyclines.
[ 
]
Evaluation of ventricular function should be carried out if an anthracycline (e.g., doxorubicin) or trastuzumab is being considered as treatment.[52][53]
The combination of an anthracycline with trastuzumab is not recommended as it may lead to increased cardiac toxicity.
Caution with dosing and patient selection is important.
A recognised common adverse effect of cancer and its treatment.
Trastuzumab is associated with a low risk of cardiotoxicity when used alone, but risk increases in combination with anthracyclines.
Evaluation of ventricular function should be carried out if an anthracycline (e.g., doxorubicin) or trastuzumab is being considered as treatment.[52][53]
The combination of an anthracycline with trastuzumab is not recommended as it may lead to increased cardiac toxicity.
Caution with dosing and patient selection is important.
People taking aromatase inhibitors who have osteoporosis require calcium, vitamin D, and bisphosphonate therapy.
Bisphosphonates are also often prescribed to people with osteopenia who are receiving aromatase inhibitors.
Vitamin D and calcium are given to people on aromatase inhibitor therapy who do not have osteoporosis.
Bone is the most common site of breast cancer metastases, and these will develop in approximately 70% of patients with MBC.[186]
Patients with bone metastases may have pain and/or pathological fractures.
Palliative radiotherapy may relieve pain from bone metastases.
There are 2 bone-seeking radioisotopes, strontium and samarium, which can be injected intravenously to relieve pain from diffuse bone disease.
The bisphosphonates disodium pamidronate and zoledronic acid, when given to patients with bone metastases, reduce the likelihood of hypercalcaemia and the need for palliative radiation.
Pleural effusions are one of the most common causes of shortness of breath.[47]
May also be a sign of lung metastasis.
Pleural effusions can be relieved by chest tube with pleurodesis, usually using talc to create an inflammatory response that obliterates the pleural space.
A sign of generalised disease.
Commonly related to decreased appetite.
Possible brain or peripheral nervous system metastases.
Surgery and postoperative radiation therapy may be options for patients with favourable prognosis and one or few (2-4) brain metastases.[143] Patients with progressive systemic disease at time of brain metastasis diagnosis should be offered HER2-targeted therapy. Tucatinib (a tyrosine kinase inhibitor) plus trastuzumab and capecitabine may be considered in patients whose disease has progressed on ≥1 HER2-directed therapy for metastatic disease.[143]
May be due to bone metastases (vertebral column) or metastases to the spinal cord.
Treatment of spinal metastasis is largely palliative. Historically, treatment has consisted of corticosteroids, surgery (decompressive laminectomy/vertebrectomy), and radiation.
Due to gastrointestinal metastases.
Management is surgical.
Use of this content is subject to our disclaimer