Meme Kanserli Bir Hastada Adjuvan Anastrozole Bağlı İrreversible Kalp Yetmezliği

Öz

Adjuvan hormonoterapi östrojen ve/veya progesteron reseptör pozitif erken evre meme kanseri MK tedavisinde önemli bir rol oynamaktadır. Bu olgu da daha önceden bilinen kalp rahatsızlığı olmayan ve bir yıl önce hormon reseptör pozitif evre IIIA MK tanısı almış bir hasta sunulmaktadır. Hasta adjuvan kemo-radyoterapi ve ardından letrozol ile tedavi edilmiştir. Letrozole bağlı eklem ağrısı sebebiyle hastanın tedavisi 1 mg/gün anastrozol olarak değiştirilmiştir. İki aylık tedavi sonrası hastada kalp yetmezliği gelişmiş olup anastrazol kullanımı bırakılmıştır. Buna rağmen hastanın ejeksiyon fraksiyonunda herhangi bir iyileşme saptanmamıştır. Aromataz inhibitörleri kalp rahatsızlığı olan MK hastalarında dikkatle kullanılmalı ve transtuzumab gibi kardiyotoksik ajanlar ile kombinasyon durumlarında daha dikkatli olunmalıdır

Anahtar Kelimeler

• Meme kanseri, Aromataz inhibitörü, Kalp yetmezliği

Irreversible Heart Failure Related to Adjuvant Anastrozole in a Patient with Breast Cancer

Abstract

Adjuvant hormonal therapy plays a major role in the treatment of estrogen and/or progesterone receptorpositive early stage breast cancer BC . In this case report, we present a postmenopausal patient who had no known history of heart disease and was diagnosed with hormone receptor-positive stage IIIA breast cancer one year ago. She was treated with adjuvant chemo-radiotherapy followed by letrozole. Because of letrozole-induced joint pain, her medication was switched to anastrazole 1 mg/day. After two months of treatment with anastrozole, the patient developed heart failure and anastrazole was discontinued. Despite discontinuation of anastrazole, no improvement was seen in the ejection fraction. Aromatase inhibitors should be used carefully in patients with BC who have a cardiac disorder and care should also be exercised in cases of combination with other cardiotoxic drugs such as trastuzumab

Keywords

• Breast cancer, Aromatase inhibitors, Heart failure

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