Table 1. Eligibility Criteria.

Inclusion Criteria

• Female gender

• Age ≥18 years

• White/European ethnicity

• Histologically-proven, early breast cancer

• Planned adjuvant or neoadjuvant anthracycline-based chemotherapy

Exclusion Criteria

• Contraindications to cardiovascular magnetic resonance

• Pre-existing cardiac disease† including: heart failure, cardiomyopathy, coronary disease, audible murmur, valvular disease, arrhythmias, pacemaker or defibrillator.

• Previous anthracycline chemotherapy

• Bilateral breast surgery (difficult venous cannulation for CMR)

• Anticipated high dose-volume cardiac irradiation, or internal mammary node irradiation

• Diagnosed hypertension or booking blood pressure ≥160/100‡ mmHg

• Diabetes mellitus

• Cerebrovascular disease

• Peripheral vascular disease

• Body mass index (BMI) ≥35‡ kg/m2

• History of pulmonary embolism

• Serum Creatinine >120μmol/L

• Bilirubin > 17μMol/l, AST or ALT >45 iu/L

• History of intravenous drug abuse or prolonged alcohol abuse

• Known HIV infection

• Uncorrected hypo/hyperthyroidism

• Haemoglobin <100 g/l

• Drugs with cardiovascular effects including ACE inhibitors, beta-blockers, antihypertensive, anti-anginal, anti-arrhythmic and diuretic agents

^†Including significant abnormalities identified on baseline CMR.

^‡Selecting cut-offs of BMI ≥35 as kg/m² and a booking blood pressure measurement ≥160/100^‡ mmHg reflected the need to balance desired cohort homogeneity against feasibility of recruitment