A study looking at the heart (cardiac) side effects of epirubicin chemotherapy for breast cancer (BETTER-CARE)

Cancer type:

Breast cancer




Phase 3

This study was trying to find out more about the heart problems that can be caused by having epirubicin as treatment for breast cancer.

Epirubicin is a chemotherapy drug that doctors have used to treat a variety of cancers for many years. It has an important role to play in the treatment of breast cancer, but it can cause side effects. It can sometimes reduce the pumping strength of the heart. There is a risk that for some people, it may cause long term heart damage.

This study followed a group of women who had epirubicin as part of their treatment for breast cancer. The researchers gathered information from

  • Heart scans
  • Blood and urine tests

The main aim of the study was to find things that could help them work out which people are at greater risk of heart damage from epirubicin.

Summary of results

The trial team found that about 1 in 5 women are likely to have an increased risk of long term heart problems after epirubicin. The researchers have results for 164 women who took part in this study.

Before having chemotherapy, the women had a heart scan known as a Cardiovascular Magnetic Resonance scan (CMR scan). This uses a powerful magnet and radio waves to form pictures of your heart and can show how much blood is pumped out with each heart beat. Everybody had another scan after they finished chemotherapy. And some women had an extra CMR scan a few days after their first dose of epirubicin.

The researchers found that the CMR scan after the first dose of epirubicin could show changes to the heart that may help to identify women who are more likely to have heart damage at the end of their treatment.

The scans after the end of treatment showed that in about 1 in 5 women (21%), the amount of blood pumped out by the heart had fallen by 5% or more. The researchers found that on average, these women weighed more than the other women in the trial. They were also more likely to have high blood pressure that had not been diagnosed or treated beforehand, and tended to have a higher percentage of body fat.

About 1 in 10 (10%) of the women taking part had high blood pressure at the beginning of the trial. The results show that these women were more likely to have changes to their heart after having epirubicin. The researchers recommend that people with high blood pressure start treatment to control it before having chemotherapy.

We have based this summary on information from the team who ran the trial.  As far as we are aware, the information they sent us has not been reviewed independently (peer reviewed Open a glossary item) or published in a medical journal yet. The figures we quote above were provided by the trial team. We have not analysed the data ourselves.

Recruitment start:

Recruitment end:

How to join a clinical trial

Please note: In order to join a trial you will need to discuss it with your doctor, unless otherwise specified.

Please note - unless we state otherwise in the summary, you need to talk to your doctor about joining a trial.

Chief Investigator

Professor Hugh Montgomery

Supported by

Department of Health
Experimental Cancer Medicine Centre (ECMC)
Imperial College London
National Institute for Health Research Cancer Research Network (NCRN)
University College London (UCL)

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Last review date

CRUK internal database number:

Oracle 753

Please note - unless we state otherwise in the summary, you need to talk to your doctor about joining a trial.

Harriet wanted to try new treatments

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“I was keen to go on a clinical trial. I wanted to try new cancer treatments and hopefully help future generations.”

Last reviewed:

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