With more breast cancer patients surviving years after their treatment, there is growing concern their hearts may not be getting adequate care, a new study finds.

Thanks to developments in chemotherapy, 87 percent of breast cancer patients are surviving five years or more.  Unfortunately many survivors suffer adverse effects on the heart caused by powerful drugs and radiation. Because of this current breast cancer treatment guidelines recommend the patient’s heart function be assessed before, during and after chemotherapy.

A new U.K. study presented at the British Cardiovascular Society finds that the majority of women undergoing breast cancer treatment are not getting the recommended follow-up heart scans.

The researchers analyzed medical records from a database focusing on the 1,229 breast cancer patients who were treated with either anthracyclines alone or combined with the monoclonal antibody Herceptin (trastuzumab) between 2003 and 2014.  Both these cancer drugs increase the risk of weakening the heart.

Despite clear guidelines that women receiving these treatments should have their heart function monitored only 625 (51 per cent) of the women underwent an echocardiogram to check that their heart function was normal before starting chemotherapy. Of these, only 238 (38 per cent) of those screened) had follow-up scans during the course of their treatment, as recommended by the guidelines.

Both chemotherapy drugs and radiation given to the chest increase the risk of heart attack, coronary heart disease and weakening of the heart muscle. Also, although this study was carried out in the U.K., cardiologists in the U.S. and elsewhere have also voiced concern for heart monitoring in patients treated for breast cancer.

Also, alhough doctors focus on older breast cancer patients for heart damage if their treatment includes Herceptin, Canadian researchers earlier this year suggested all patients on Herceptin the drug should be monitored, based on the results of a their study that the drug significantly increased the risk for major cardiac events among all patients, regardless of age.