Q. Can a breast cancer patient with cardiac problems undergo chemotherapy?

Answered by
Dr. Dinesh Kumar
and medically reviewed by Dr. Chithranjali Ravichandran
This is a premium question & answer published on Apr 30, 2022

Hi doctor,

My mother is 75 years old, and she recently had a modified radical mastectomy for stage 2B invasive carcinoma (tumor size is 3x3, and two nodes of 19 dissected and had metastasis). Her biopsy results say that it is NHS-grade 3, and positive lymph vascular and perineural invasion is seen. The skin, areola, and nipple are free of tumors. It is a p2t2N1a and DCIS-intermediate. The tumor is hormone-positive with both estrogen and progesterone. HER2 is negative.

She is a cardiac patient having atrial fibrillation and hypertension.

Can you please advise treatment options considering her age?

Thank you.



Welcome to

Considering her age and the relatively good profile of breast cancer she had, I would suggest that we may avoid chemotherapy. Instead, she may receive radiotherapy and oral hormonal therapy (Letrozole).

Thanks and regards.

Hi doctor,

Thanks for your response.

May I know the other oral hormonal drugs and their side effects?

Thank you.



Welcome back to

Letrozole is the safest drug for her. It may cause some bone aches, and she has to be on long-term calcium supplementation. There are a lot many other drugs also (from the same class of Letrozole, as well as from different classes). These are generally reserved for advanced diseases and they are Tamoxifen, Fulvestrant, and Anastrozole.

Thanks and regards.

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