Anemia Triples Risk of Local Recurrence in Breast Cancer Patients

No differences seen in overall survival, metastasis when chemo triggered low red blood cell count

By Nicholas Mulcahy
HealthDay Reporter

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THURSDAY, April 3 (HealthDay News) -- Breast cancer patients who develop anemia during chemotherapy face almost three times the risk of a recurrence in the same area of the affected breast, new research suggests.

The Austrian study was a re-analysis of information from a clinical trial that took place in the 1990s. Importantly, the findings also indicated that anemia did alter overall survival or significantly increase the risk of cancer occurring in a patient's other breast or spreading elsewhere in the body. Anemia, a common side effect of chemotherapy, is a low red blood cell count that can cause fatigue and reduced quality of life.

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"This study is definitely not aimed at changing current practice," said study author Dr. Peter Dubsky, of the Medical University of Vienna. "This is a retrospective analysis that has yielded quite controversial data. The conclusion from our study is aimed at experimental and clinical oncologic research. Anemia is associated with a high likelihood of tumor hypoxia [too little oxygen in the blood]."

The chemotherapy used in the study was a combination of cyclophosphamide, methotrexate and 5-fluorouracil (CMF). The problems of anemia and related local recurrence are probably not limited to just this form of chemotherapy, noted Dr. Douglas Yee, director of the University of Minnesota Cancer Center. "I think this effect would be seen with any chemotherapy."

CMF is no longer commonly used in the treatment of breast cancer and has been replaced by other forms of chemotherapy such as taxanes, added Dr. Barry C. Lembersky, a clinical associate professor of medicine at the University of Pittsburgh School of Medicine. Also, there is a trend in breast cancer treatment to use chemotherapy less often, he said.

"Nowadays, there is a more selective use of chemotherapy, which tends to be used when a tumor is not stimulated by estrogen, lymph nodes are involved, or the genetic/clinical profile is suited for chemotherapy," he explained.

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