Adriamycin and Herceptin

I have been told in the past that if a woman with breast cancer had had Adriamycin in the past, it would prevent her from having Herceptin later on because of the high risk of cardiomyopathy from the combination of these two drugs even if she was her2-new+. I understand that some women are these days given this combination anyway. Is the risk of cardiomyopathy less than at first believed?

[Connie 1]

TI Use of chemotherapy plus a monoclonal antibody against HER2 for metastatic breast cancer that overexpresses HER2.  
AU Slamon DJ; Leyland-Jones B; Shak S; Fuchs H; Paton V; Bajamonde A; Fleming T; Eiermann W; Wolter J; Pegram M; Baselga J; Norton L  
SO N Engl J Med 2001 Mar 15;344(11):783-92.  

is the study that raised concerns about cardiomyopathy with the addition of trastuzumab  to anthracycline-based chemotherapy (e.g. adriamycin).



Buzdar, AU, Hunt, K, Smith, T, et al. Significantly higher pathological complete remission rate following neoadjuvant therapy with trastuzumab, paclitaxel, and anthracycline-containing chemotherapy: initial results of a randomized trial in operable breast cancer with Her2 positive disease (abstract). Proc Am Soc Clin Oncol 2004; 22:7s.

is the study that challenges those early findings, and because of this more recent study, some women are receiving this combination ONLY in the setting of a clinical trial.  

[often]

I had AC, 4 treatments, starting November of 2001.  In May of 2004 I was diagnosed with Congestive Heart Failure.  Considering the cardiomyopathy/chf is treatable, and in my case reversible, I think I wouldn't care and would go for the best chance possible on hitting the mets.  But that is hindsight from someone NOT dealing with it.