Statins for Reduction of Cardiac Toxicity in Patients Receiving HER2 Targeted Therapy.

Inclusion Criteria: - Histologically and/or cytologically confirmed diagnosis of Stage I-III female breast cancer (including inflammatory breast cancer) - Scheduled to receive neoadjuvant/adjuvant HER2 targeted therapy - Between ≥18 years of age - Female patients of childbearing potential must have a negative pregnancy test (serum or urine) prior to enrollment. Female patients must agree to use effective barrier contraception during the period of therapy - Baseline LVEF ≥ 50% - Prior cancers allowed if no evidence of disease in last 5 years - ECOG 0-2 - No prior history of treatment with HER2 targeted therapy or anthracyclines based chemotherapy - Adequate bone marrow function: I. ANC ≥ 1000/uL II. platelet count ≥ 100,000/uL III. hemoglobin ≥ 9.0 g/dL • Adequate hepatic function: I. Total bilirubin ≤ 1.5 X ULN II. AST (SGOT) ≤ 5 X ULN III. ALT (SGPT) ≤ 5 X ULN - Adequate renal function, Creatinine < 1.5x institutional ULN or calculated creatinine clearance ≥ 50 mL/min as estimated using the Cockcroft-Gault formula - Ability to understand the nature of this study protocol and give written informed consent - Willingness and ability to comply with scheduled visits, treatment plans, laboratory tests, and other study procedures Exclusion Criteria: - Participants with stage IV breast cancer - Participants currently taking statins - Uncontrolled hypertension (systolic blood pressure >190 mm Hg or diastolic blood pressure >100 mm Hg) - No active liver disease - Current use of CYP 3A4 inhibitors - Any condition including the presence of laboratory abnormalities, which, in the opinion of the investigator places the subject at unacceptable risk if he/she were to participate in the study - Life expectancy < 12 weeks - Pregnancy (positive pregnancy test) or lactation - Pre-existing sensory neuropathy > grade one - Has significant cardiovascular disease, such as: LVEF < 50% at baseline as assessed by ECHO (preferred) i) Class III or Class IV myocardial disease as described by the New York Heart Association ii) Recent history (within 6 months prior to enrollment) of myocardial infarction; or iii) Symptomatic arrhythmia at the time of randomization - Major surgery without complete recovery in the past four weeks prior to screening - Concurrent active infection - Participant with uncontrolled and/ or active infection with HIV, Hepatitis B or Hepatitis C - Participant who has a history of allergy or hypersensitivity to any of the study drugs - Participant with a history of interstitial lung disease, history of slowly progressive dyspnea and unproductive cough, sarcoidosis, silicosis, interstitial pulmonary fibrosis, pulmonary hypersensitivity pneumonitis - Any significant medical condition, laboratory abnormality, or psychiatric illness that would prevent the subject from participating in the study