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June 2, 2026Nihon Rinsho Geka Gakkai Zasshi (Journal of Japan Surgical Association)0 citationsOpen Access

A Case of HER2-positive Breast Cancer with Cancer Treatment-related Heart Failure after Breast Reconstruction Surgery

MAMitsuki ADACHIMYMiwa YoshidaAYAyuha Yoshizawa

Key Result

A 49-year-old woman with HER2-positive breast cancer developed cancer treatment-related heart failure with LVEF dropping from 66% to 28% after breast reconstruction surgery following chemotherapy.

Key Points

  • To report a case of heart failure related to cancer treatment in a patient with HER2-positive breast cancer following reconstruction surgery.
  • Patient underwent left mastectomy, sentinel lymph node biopsy, and expander insertion.
  • Adjuvant therapy included EC regimen and docetaxel with pertuzumab and trastuzumab.
  • Heart failure diagnosed post-surgery based on reduced ventricular ejection fraction and elevated BNP.
  • Ventricular ejection fraction decreased from 66% to 28% post-surgery.
  • Heart failure persisted despite treatment, with no recovery above 50% ejection fraction after 6 months.
  • Remaining doses of pertuzumab and trastuzumab were discontinued to avoid severe cardiovascular complications.

Study Design

Type

Case Report (n=1)

Multicenter

No

Structured PICO

P
Population
1 49-year-old female with left breast cancer (HER2 type, cT2N0M0 cStage IIA)
I
Intervention
Adjuvant chemotherapy (EC therapy 4 courses, docetaxel, pertuzumab, trastuzumab 4 courses) followed by breast reconstruction surgery
O
Outcome
Development of cancer treatment-related heart failure (CTRCD)safety

This case highlights the critical need for early detection and management of cancer treatment-related cardiac dysfunction to prevent fatal complications and allow continuation of necessary cancer therapies.

Limitations

  • Inadequate preoperative evaluation of cancer therapeutics-related cardiac dysfunction (CTRCD)
  • Insufficient perioperative heart failure prevention management

Abstract

症例は49歳，女性．左乳癌（HER2タイプ）cT2N0M0 cStage IIAに対して，患者の希望で手術を先行し，左乳房全切除・センチネルリンパ節生検→腋窩郭清・組織拡張器挿入術を行った．術後補助薬物療法（EC療法4コース，ドセタキセル・ペルツズマブ・トラスツズマブ4コース）を施行後，全身麻酔下でインプラントによる乳房再建術を行った．術後7日目に安静時呼吸困難が出現し，胸部X線で心拡大と胸水貯留，BNP上昇，左室駆出率低下（ベースライン66％→28％）を認め，がん治療関連心不全と診断された．心不全の治療開始後6カ月以上経過しても左室駆出率が50％以上に回復しなかったため，当初予定していたペルツズマブ・トラスツズマブの残りの投与を中止した．がん治療に伴う致命的な心血管合併症を回避し，必要ながん治療を継続するためには，がん治療関連心機能障害の予防・早期発見・早期治療に努めることが重要である．

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Cite This Study

ADACHI et al. (2025) conducted a case report in HER2-positive breast cancer (n=1). Adjuvant chemotherapy (EC followed by docetaxel, pertuzumab, trastuzumab) and breast reconstruction surgery was evaluated on Development of cancer treatment-related heart failure. A 49-year-old woman with HER2-positive breast cancer developed cancer treatment-related heart failure with LVEF dropping from 66% to 28% after breast reconstruction surgery following chemotherapy.

synapsesocial.com/papers/6a1e728f30b38c64201b5befhttps://doi.org/10.3919/jjsa.86.1446
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