Case Report
Copyright ©The Author(s) 2019. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Jun 26, 2019; 7(12): 1492-1498
Published online Jun 26, 2019. doi: 10.12998/wjcc.v7.i12.1492
Secondary lymphoma develops in the setting of heart failure when treating breast cancer: A case report
Sen Han, Tao An, Wei-Ping Liu, Yu-Qin Song, Jun Zhu
Sen Han, Wei-Ping Liu, Yu-Qin Song, Jun Zhu, Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Department of Lymphoma, Peking University Cancer Hospital and Institute, Beijing 100142, China
Tao An, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Science and Peking Union Medical College, Heart Failure Center, Beijing 100142, China
Author contributions: Zhu J and Han S designed and wrote the report; An T reviewed the manuscript for its intellectual content; Liu WP and Song YQ performed the analysis and evaluations; all authors have read and approved the final manuscript.
Informed consent statement: The patient involved in this study gave written informed consent authorizing the use and disclosure of her protected health information.
Conflict-of-interest statement: The authors of this manuscript have no conflicts of interest to disclose.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
Corresponding author: Jun Zhu, MD, Professor, Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Department of Lymphoma, Peking University Cancer Hospital and Institute, No. 52, Fucheng Road, Haidian District, Beijing 100142, China.
Telephone: +86-10-88196109 Fax: +86-10-88196115
Received: February 2, 2019
Peer-review started: February 11, 2019
First decision: March 9, 2019
Revised: April 24, 2019
Accepted: May 2, 2019
Article in press: May 2, 2019
Published online: June 26, 2019

Cardiovascular side effects occur frequently during anti-cancer treatment, and there is a growing concern that they may lead to premature morbidity and death.


A 32-year-old woman was diagnosed with breast cancer. After comprehensive treatment with neoadjuvant chemotherapy, surgery, postoperative adjuvant chemotherapy, postoperative adjuvant radiotherapy, and endocrine therapy, her breast cancer was cured. However, heart failure associated with anti-cancer treatment presented, most probably related to chemotherapy containing anthracycline. After active treatment, her cardiac function returned to normal. Unfortunately, follow-up visits revealed a second primary malignancy, lymphoma. After multiple courses of chemotherapy combined with targeted therapy, her lymphoma acquired complete remission and no cardiotoxicity was observed again. Heart failure related to breast treatment may be reversible.


Using alternatives to anthracycline in patients with lymphoma who are at risk of cardiac failure may preserve cardiac function.

Keywords: Breast cancer, Chemotherapy, Cardiac toxicity, Heart failure, Anthracycline, Cardio-oncology, Case report

Core tip: Anti-cancer treatment is frequently associated with the development of cardiovascular side effects. A 32-year-old woman diagnosed and treated for breast cancer was cured after comprehensive treatment. Unfortunately, the patient later presented with heart failure associated with anti-cancer treatment involving the use of anthracycline. Her cardiac function returned to normal after active treatment but a second primary malignancy, lymphoma, was detected in subsequent visits. Following multiple courses of chemotherapy combined with targeted therapy, there was complete remission of the acquired lymphoma with no re-occurrence of cardiotoxicity. Thus, heart failure related to breast cancer treatment may be reversible. Furthermore, anthracycline should be avoided in patients at risk of cardiac failure having lymphoma to preserve cardiac function.