Editorial Comment:The impact of radiotherapy, trastuzumab and hormonal therapy on cardiac fibrosis. More is worse?

Radiotherapy (RT) for early breast cancer (EBC) has proven capable of reducing the rates of recurrence and death from the disease. Similarly, trastuzumab, an anti-human epidermal growth factor receptor 2 (HER2) antibody, has significantly improved the prognosis of breast cancer patients in both the adjuvant and metastatic settings. However, major concerns have arisen about these treatments because both have been linked to cardiac toxicity, the former increasing the risk of ischemic heart disease, the latter, heart failure.