The approach to
breast cancer has changed in recent decades due to significant advances in screening, early diagnosis, and treatment; however, the risk of cardiovascular injury induced by
chemotherapy has remained similar.
Anthracyclines are the most common agents used in
breast cancer treatment and may lead to
cardiotoxicity, which appears to have a direct relationship with accumulated dose and
duration of treatment. Therefore, the use of cardiac
biomarkers derived from those used in
cardiac disease diagnosis has been applied to the early identification, evaluation, and
cardiotoxicity monitoring during
chemotherapy. Cardiac
troponins (
cTn) have high specificities and high sensitivity in myocardial injury and are used in the diagnosis and risk stratification of
acute coronary syndromes.
cTn have been validated by clinical studies in the
cardiotoxicity diagnosis and prognosis in patients treated with high doses of
anthracyclines alone or in combination, mainly with
trastuzumab. Thus, the identification of
cardiotoxicity through
cTn in the preclinical phase would be crucial for the application of preventive strategies. Here, we analyzed 23 cross-sectional, prospective and retrospective studies using
cTn as the
biomarker of
cardiotoxicity in patients with
breast cancer receiving treatment with
anthracyclines. Studies showed that the association of
cTn with different
biomarkers can contribute to the early diagnosis of
cardiotoxicity; however the main evidence is that low
cTn levels is related to a better outcome with a good negative predictive value (NPV). In conclusion, different studies are still necessary for the adoption of
cTn as a routine clinical
biomarker in patients with
breast cancer receiving
anthracycline treatment.