This study prospectively examined 109 breast cancer patients in Brazil receiving trastuzumab-based treatment to evaluate cardiotoxicity. Over half (53.2%) experienced cardiac events and 38.5% saw a decrease in left ventricular ejection fraction of over 10% from baseline. The incidence of cardiotoxicity was higher in patients with metastatic (75%) versus early-stage (45.7%) breast cancer. Trastuzumab treatment was discontinued in 32.1% of patients due to cardiotoxicity, though 66% were later able to resume treatment. No risk factors were identified as significantly associated with cardiotoxicity.