Herceptin and Heart Palpitations, 4 doses to go?


I am posting on behalf of my mum as her English is not very well and I am concerned about her health.


A little background - My mum was diagnosed with Breast Cancer last May. Pathology indicated a 22mm Grade 2 Invasive cancer with no lymph nodes affected. It is ER, PR and HER2 positive.


The cancer was removed via an operation last June and after that’s she started Chemotherapy (FEC-T) in August/September 2017. She was only able to make it to the 4th round - All 3 rounds of “FEC” and 1 round of “T”. It just got too much for her and the treatment had to be stopped last year December 2017. Our consultant wasn’t that concerned of stopping it early as she was having targeted treatment after.


After that she went through the whole course of Radiotherapy which ended in February 2018. Since November 2017 she has been on a regular dose of Herceptin every 3 weeks and she is taking Anastrozole every day for the next 5 years.


Her Heart Ejection Fraction from her last MRI scan indicated function at 72%! To me this seems strange as I thought that anyone on Herceptin would have some decrease in heart function?


I guess the concern is the Herceptin. She has had the majority of it with 4 doses to go but recently she has been experiencing heart palpitations a few times throughout the day, every day. She explains that each episode of heart palpitations only lasts 1-2 seconds. Is this to be concerned about as she has not complained about shortness of breath, tiredness, swelling of ankles or chest pains but just sometimes a runny nose, which I understand is one of the side effects?


I want to suggest to the consultant that she has another MRI before the next dose of Herceptin just to ensure that nothing is wrong with the heart. I am wondering if stopping now with 4 doses to go will make any difference as to having the extra 4 doses?


Sorry for the long winded post and thanks in advance.

Hello Gentle,

Sorry to hear about your mum. It is lovely to see she has a supportive daughter in you.

If you need to, you could always speak with a nurse via the helpline tomorrow or post on the Ask The Nurses section.

My cancer had similar characteristics to your mum’s i.e. Her+ ER +PR+. I can also identify with the runny nose as with the regular MUGA or Echo scans to check heart function during Herceptin treatment.

I had an episode of palpatations some years ago before cancer. No cause was identified on medical investigation. I put it down to going through a stressful period of life!

Stress, exercise, medication or rarely a medical condition can trigger palpatations. A number of breast cancer treatments, whether chemo, radio, targeted or hormone treatment can affect our heart and it’s function.

With new symptoms, I always think it good to get the situation checked out so maybe best to discuss it with BCN/Oncologist/with nurses before next Herceptin given/or even GP.

If your mum’s last heart function result was at 72%, was this higher or lower than the one before? Has there been much of a movement from her baseline scan?

A measure of 72% would usually indicate healthy heart function. I am sure if the results had thrown up any concern at the time, this would have been discussed at the time.

Not everyone on Herceptin has reduced heart function or heart damage. As your mum is at her last 4 treatments, is she due another scan soon anyway? I had my last one before treatment 16.

No one can really answer the question of whether missing 4 doses will definitely make a difference. It may be in the near future, based on recent research currently under discussion, that Herceptin treatment is reduced to half of what it is now. However, at the current time, the full 18/12 months is still the norm.

Take care Gentle. Warmest regards to you and your mum X ?