|Gilles Chaplain, Chantal Milan, Catherine Sgro, et al.|
|Abramson Cancer Center of the University of Pennsylvania|
| Last Modified: November 1, 2001
Reviewers: Li Liu, MD
Précis: Adjuvant treatment for breast cancer increased leukemia risk
IntroductionSince the mid-1970s, adjuvant chemotherapy has been widely used to treat breast cancer with regional lymph-node involvement. More recently, systemic drug therapy has been given to women with localized disease, most of whom survive for many years without a recurrence of cancer. It has been well documented that patients with breast cancer who are treated with chemotherapy, particularly regimens containing melphalan, are at increased risk of secondary leukemia (Cancer Research 1990 May 1;50(9):2741-6). In this study, the researchers evaluated the risk of acute leukemia after adjuvant chemotherapy, especially with topoisomerase II inhibitors.
MethodA total of 3093 French women younger than 85 years who underwent surgery for breast cancer between 1982 and 1996 were evaluated. Approximately 57% of patients received radiotherapy alone and 31% had combination of radiotherapy and chemotherapy.
DiscussionIn this study, combined adjuvant radiotherapy and chemotherapy including mitoxantrone is associated with an increased risk of acute leukemia in women with breast cancer. In patients who are treated with newer chemotherapy agents, such as Taxol, the risk of acute leukemia remains unknown and warrants further investigation.