Cardiac dysfunction (LVEF <50%) — anthracycline + trastuzumab/pertuzumab + T-DM1/T-DXd al...

Deterministic view of the source YAML entity. Clinical authority remains with the cited source IDs and reviewer sign-off state.

ID	`RF-BREAST-ORGAN-DYSFUNCTION`
Type	Red flag
Status	pending_clinical_signoff
Diseases	`DIS-BREAST`
Sources	`SRC-ESMO-BREAST-EARLY-2024` `SRC-NCCN-BREAST-2025`

Red Flag Origin

Definition	Cardiac dysfunction (LVEF <50%) — anthracycline + trastuzumab/pertuzumab + T-DM1/T-DXd all carry cardiotoxicity risk; baseline echo + serial monitoring required.
Clinical direction	investigate
Category	organ-dysfunction

Trigger Logic

{
  "any_of": [
    {
      "comparator": "<",
      "finding": "lvef_percent",
      "threshold": 50
    },
    {
      "finding": "cardiac_dysfunction_baseline",
      "value": true
    }
  ],
  "type": "lab_value"
}

Notes

Anthracycline + trastuzumab cumulative cardiotoxicity well-established. Modern strategies: cardio-oncology consult; substitute non-anthracycline regimen (TC for HER2-) or modified HER2-backbone if anthracycline contraindicated. T-DXd cardiotoxicity less than naked trastuzumab.

Used By

Indications

IND-BREAST-HER2-POS-EARLY-NEOADJUVANT - IND-BREAST-HER2-POS-EARLY-NEOADJUVANT
IND-BREAST-TNBC-EARLY-NEOADJUVANT - IND-BREAST-TNBC-EARLY-NEOADJUVANT