Protecting your heart health during and after breast cancer treatments
September 15, 2026
Breast cancer screening and treatment have improved substantially in recent decades, with increasingly precise and effective options. Nearly two-thirds of breast cancers in women are diagnosed before the cancer has spread. For early stage, localized disease, the five-year relative survival rate approaches 100%.
This progress also brings an important parallel discussion into focus: protecting women’s heart health during and after breast cancer treatment.
Heart disease remains the leading cause of death for both men and women in the U.S. Certain breast cancer and heart disease risk factors overlap, including obesity, lack of regular exercise, smoking, and alcohol use.
Breast cancer care may include chemotherapy, radiation, immunotherapy, hormonal therapy, and established or emerging molecularly targeted therapies. Depending on the treatment, dose, duration, and a patient’s baseline health, these therapies can affect the heart and blood vessels during treatment or years later. Potential complications include high blood pressure, abnormal heart rhythms, reduced heart muscle function, inflammation, blood clots, coronary or valvular disease, and heart failure. Hormonal therapies can also contribute to longer-term cardiovascular and metabolic risk, making continued assessment important throughout survivorship.
As more breast cancers are detected earlier and treated successfully, many patients live for decades after diagnosis. This longer survival makes it especially important to address both pre-existing cardiovascular risk factors and the early and late effects of cancer therapy.
In a recent review published in JAMA Cardiology, UT Southwestern researchers examined cardiovascular health across the lifespan of women with breast cancer. The review emphasizes that cardiovascular disease may become a major long-term health concern for survivors, particularly when treatment-related effects compound traditional risk factors.
The message is clear: Heart health should be a long-term priority in breast cancer care. At UT Southwestern, patients have a full team of experts dedicated to this specialty.
UT Southwestern is a top-15 nationally ranked cardiology and heart surgery program and a National Cancer Institute-designated comprehensive cancer center. Through our dedicated Cardio-Oncology Program, recognized as a Center of Excellence by the International Cardio-Oncology Society, integrated in the UTSW Harold C. Simmons Comprehensive Cancer Center, we connect diagnosed patients with Breast Oncology experts, heart health experts, and women’s health specialists.
This team cares for patients at every stage of life, from cancer treatment to pregnancy planning, menopause, and healthy aging through the lens of cardiovascular health.
Anticipating and managing cardiovascular risks
At UT Southwestern, the Breast Cancer and Cardio-Oncology programs collaborate closely with specialists in cardiovascular medicine, women’s heart health, maternal-fetal medicine, and other disciplines to support patients throughout treatment and survivorship. This multidisciplinary model is particularly important for patients with pre-existing heart disease, cardiovascular effects of cancer therapy, or breast cancer diagnosed during pregnancy. The goal is to coordinate care across specialties while addressing each patient’s individual clinical needs and priorities.
“Many women with breast cancer are understandably focused on treating the cancer itself,” said Vlad Zaha, M.D., Ph.D., Associate Professor of Internal Medicine and Medical Director of the Cardio-Oncology Center of Excellence. “Our goal is to help them do that safely by protecting heart health throughout treatment and survivorship. The close collaboration between our Breast Cancer and Cardio-Oncology teams allows us to anticipate risks, address concerns early, and keep care aligned with each patient’s priorities.”
The first step: Establishing your heart-health baseline
Every patient with breast cancer should have a cardiovascular risk assessment before treatment begins. This evaluation helps clinicians identify personal and family risk factors for heart disease, including:
- High blood pressure
- High cholesterol
- Diabetes
- Excess weight or obesity
- Limited exercise
- Smoking history
- Unhealthy nutritional patterns
- Insufficient or poor-quality sleep
Depending on the findings and the planned cancer therapy, your doctor may recommend an electrocardiogram (ECG), an echocardiogram, or other testing to evaluate heart function. These results establish a baseline and help the care team identify appropriate steps to reduce future cardiovascular risk.
This assessment is especially important for younger patients, who may live for decades after breast cancer treatment. Heart disease risk factors in young adults can accumulate over time, while treatment-related complications may emerge years after therapy. Patients age 50 and older are more likely to have established cardiovascular risk factors that should be identified and managed before, during, and after treatment.
The goal is to create a personalized care plan that is effective against breast cancer and that supports your future heart health.
During and after cancer treatment
The UTSW Breast Oncology and Cardio-Oncology teams work together to select effective cancer therapies while reducing cardiovascular risk when possible. Modern radiation therapy uses image guidance and precise treatment fields to limit exposure of surrounding healthy tissues, including the heart. Chemotherapy, immunotherapy, hormonal therapy, and molecularly targeted therapies have different cardiovascular risk profiles, so monitoring is tailored to the specific treatment, cumulative exposure, and each patient’s baseline risk.
During treatment, the care team monitors for symptoms and clinically meaningful changes from the cardiovascular baseline. Depending on the therapy and risk level, this may include blood pressure checks, laboratory testing, electrocardiography, and noninvasive cardiovascular imaging. The goal is to detect complications early, treat them promptly, and avoid unnecessary interruption of effective cancer therapy.
Over the long term, cardiovascular health depends on both appropriate medical follow-up and sustainable habits involving nutrition, physical activity, sleep, and tobacco avoidance. We recommend these core steps:
- Get regular exercise, such as walking, swimming, and strength training.
- Eat a heart-healthy diet that prioritizes whole foods.
- Maintain a healthy weight and metabolism.
- Control blood pressure, cholesterol, and diabetes.
- Avoid tobacco products.
- Get restful sleep.
Taking these steps can lower the risk of heart attack and stroke; they also support overall health and quality of life.
After breast cancer treatment, the frequency and duration of cardio-oncology follow-up should reflect the therapies received, cardiovascular findings during treatment, and each patient’s ongoing risk. The team can monitor risk factors, evaluate possible heart disease symptoms, and coordinate care with oncology, primary care, and other specialists when needed.
Younger women who are considering pregnancy may need specialized evaluation before conception and monitoring during pregnancy. Pregnancy increases blood volume and cardiac workload and can unmask or worsen underlying cardiovascular disease. We can connect patients with maternal-fetal medicine experts and other specialists who can help assess and manage cardiovascular risk during pregnancy. With individualized planning and appropriate care, many women can safely pursue pregnancy after breast cancer treatment.
Reverse cardio-oncology and lifelong heart health
We know that cancer treatment can affect heart health. Risk factors such as obesity, diabetes, and high cholesterol are linked to both heart disease and some cancers, including some forms of breast cancer.
Emerging research also examines the relationship in the opposite direction, an area sometimes called reverse cardio-oncology. Cardiovascular disease and cancer share several biological pathways and risk factors, and scientists are studying whether some cardiovascular conditions are increasing subsequent cancer risk. It is not yet known whether managing cardiovascular risk factors or treating cardiovascular conditions such as coronary artery disease, hypertension, or atrial fibrillation directly reduces the likelihood of developing cancer.
While more research is needed to draw firm conclusions, it’s a reminder that taking care of your heart supports your health in many ways beyond lowering the risk of heart attack or stroke.
After breast cancer, many patients want to move forward without allowing medical care to dominate daily life. Cardio-oncology support can provide a practical plan for surveillance, prevention, and treatment when needed, while helping patients remain focused on long-term health and quality of life.
If you have breast cancer or are at increased risk, we can help you make heart disease screening and prevention a part of your care plan from the start.
To talk with experts about women’s heart health after breast cancer, make an appointment by calling 214-645-4673 or request an appointment online.
