Study population
A total of fifty patients were enrolled into the study and of those 28 (56%) patients were followed up to 12 months (Figure 1). Of the patients analysed the median age was 48 years (IQR 44.5-59.0). Most of the patients (86%) had advanced stages of breast cancer (stage III/IV) with a good Karnofsky performance status between 80-90%. The median LVEF measurement at 12 months was 61.5% (IQR 58.1-77.3) and the median cumulative doxorubicin dose was 238.89 mg m-2 (Table 1).Two (7%) out of the 28 patients received single agent doxorubicin, 9 (32%) received doxorubicin plus cyclophosphamide doublet and 17 (61%) of patients received doxorubicin, cyclophosphamide followed by paclitaxel(Table S1) Three (11%) patients developed cardiotoxicity and cumulatively these patients received the following doses of doxorubicin 240 mg m-2, 281 mg m-2 and 360 mg m-2. The final LVEF measurements of the three patients after the 12-month follow up were 18.2%, 34.9% and 39%. One of the patients received single agent doxorubicin while the remaining two received a combination therapy of doxorubicin plus cyclophosphamide followed by paclitaxel. The three patients were all hypertensive and additionally one had diabetes mellitus.