ORIGINAL RESEARCH article
Front. Oncol.
Sec. Cardio-Oncology
This article is part of the Research TopicCardio-Oncology in the Era of Precision Medicine: Risk Stratification, Surveillance, and Cardioprotection Across the Cancer ContinuumView all 3 articles
Prospective Evaluation of Chemotherapy-Induced Dyslipidemia in Early Breast Cancer: Implications for Cardiovascular Risk
Provisionally accepted
- 1Department of Oncology, Stefan Kukura Hospital, Michalovce, Slovakia, Michalovce, Slovakia
- 2Faculty of Medicine P.J. Safarik University Košice, Košice, Slovakia
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Background Cardiovascular disease is a leading cause of long-term mortality among breast cancer survivors, yet chemotherapy-induced dyslipidemia remains an underrecognized component of survivorship care. Methods In this prospective, single-center study, 56 women with clinical stage IB–IIIB early breast cancer received standardized anthracycline-and taxane-based chemotherapy. Fasting lipid profiles including low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), total cholesterol, and triglycerides, were assessed at four timepoints: baseline, post–anthracycline–cyclophosphamide phase, end of treatment, and 3-month follow-up. Longitudinal changes were analysed using non-parametric tests and multivariable linear regression. Results Baseline dyslipidemia was present in 78.4% of patients. Chemotherapy significantly altered all lipid parameters, with changes in total cholesterol (p = 0.004), LDL-C (p = 0.007), HDL-C (p < 0.001), and triglycerides (p = 0.002). The most pronounced alterations occurred during the anthracycline-based phase. Elevated LDL-C and reduced HDL-C levels persisted at follow-up. Lipid changes were not consistently associated with age, BMI, or menopausal status. Conclusion Standard chemotherapy induces sustained proatherogenic lipid shifts in women with early breast cancer, independent of baseline cardiovascular risk factors. The unexpectedly high prevalence of dyslipidemia among premenopausal women challenges traditional assumptions of cardiometabolic protection in younger patients. These findings support the integration of lipid monitoring and early cardiovascular risk management into survivorship care. Clinical trial registration: NCT06958783, https://clinicaltrials.gov/study/NCT06958783
Keywords: breast cancer, Cardio-oncology, cardiovascular risk, chemotherapy, Dyslipidemia
Received: 01 Aug 2025; Accepted: 16 Dec 2025.
Copyright: © 2025 Rusinova, Medvedieva, Santova and Kozarova. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Miriam Kozarova
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