O’Brien P, et al. - In this systematic review of the literature, researchers investigated whether routine baseline cardiac assessments before adjuvant anthracycline-based chemotherapy (AA) for early-stage breast cancer (EBC) has any clinical utility and which patients for whom baseline cardiac assessments may not be necessary. They identified eight studies that met predefined criteria, of whom six (n = 2,545) reported rates of abnormal left ventricular ejection fraction (LVEF) and six (n = 1,713) reported rates of change in chemotherapy decision. Abnormal baseline LVEF and a change in chemotherapy decision was seen in 2.5% and 1.6% of patients, respectively. These rates were not significantly influenced by the underlying imaging modality (echocardiography vs multi-gated acquisition scan) or inclusion of patients with metastatic disease in subset analyses. Across studies, no consistently identified underlying predictors of abnormal baseline LVEF were documented. Overall, a low yield of routine baseline cardiac assessments prior to AA and infrequent impact of this strategy on clinical management was seen in all EBC patients.