Breast cancer survivors could avoid lifelong heart medication, research suggests

Many breast cancer survivors whose treatment caused them to develop problems with their heart function can safely stop their medication after their heart recovers and most won't need to continue treatment long term, according to a study¹ funded by the British Heart Foundation and presented at the European Society of Cardiology Congress in Munich.

The trial involved 90 women who had recovered from heart problems caused by a specific type of breast cancer treatment. Most were in their 40s and 50s and would previously have been advised to stay on heart medication for life, due to fears their heart function would decline once the drugs were stopped.

Everyone in the study was randomly assigned to either gradually withdraw from their heart failure medication (46 women) or to continue taking it (44 women). They were followed closely for one year with blood tests, quality-of life questionnaires and cardiac MRI scans to check whether their heart function had worsened.

Researchers found that 98 per cent of the group who stopped taking their heart medication had no change in their heart function after one year, with only one woman experiencing a decline in her heart's pumping ability.

Women who came off their medication also reported a slightly better quality of life at 12 months than those who continued, based on their scores on questionnaires designed to measure quality of life in people with heart failure.

Overall, left ventricular ejection fraction remained stable in both groups (minus one per cent in the withdrawal group and minus 0.2 per cent in the continuation group) with no significant differences between the two groups after one year (withdrawal group 55.2 per cent compared to 55.6 per cent in continuation group).

None of the women in the trial reported any heart failure symptoms, required hospital treatment or experienced any other heart problems during the trial.

The women will continue to be followed up over the next five years to monitor their heart health. But the researchers suggest their findings can start important conversations between survivors and their doctors about whether they need to continue treatment long-term.

Professor Charlotte Manisty, Head of Clinical Cardiovascular Science at University College London and consultant cardiologist at Barts Heart Centre and University College Hospitals London, led the trial, said, "Our study provides the first evidence that heart failure therapies can be safely stopped in survivors whose hearts have recovered, with the support of ongoing close monitoring. We hope these findings will be encouraging for survivors and their doctors, giving hope for a future free from treatment."

Dr Sonya Babu-Narayan, clinical director at the British Heart Foundation and consultant cardiologist, added, "These findings will be hugely encouraging for the thousands of breast cancer survivors whose heart health has been affected by lifesaving cancer treatment. The study results give hope that many women will be able to safely stop medicines once their heart has recovered.”

The study was also supported by the National Institute for Health and Care Research Biomedical Research Centre: UCLH.

References

1. Dowsing B et al (2026). HER-SAFE: An open-label, randomised controlled trial to investigate the safety of withdrawal of pharmacological treatment for recovered HER2 targeted therapy related cardiac dysfunction. European Heart Journal.

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