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Chemotherapy Anemia Linked to Breast Cancer Relapse

In premenopausal women, anemia triples risk of a local relapse within five years

WEDNESDAY, April 2 (HealthDay News) -- Premenopausal patients with early-stage primary breast cancer who develop anemia after receiving adjuvant cyclophosphamide/methotrexate/5-fluorouracil chemotherapy have a significantly increased risk of local relapse, according to research published in the April 1 issue of Clinical Cancer Research.

Peter Dubsky, M.D., of the Medical University Vienna in Vienna, Austria, and colleagues studied 424 patients with hormone receptor-expressing tumors, 77 (18.2 percent) of whom developed anemia during adjuvant chemotherapy.

After a median follow-up of five years, the researchers found that significantly more anemic than non-anemic patients had a local relapse (19.6 percent versus 8.9 percent) and determined that they had an almost triple risk of cancer recurrence (relative risk 2.96). Despite finding that mastectomy was associated with anemia (26 percent versus 13.7 percent for breast conserving surgery), the researchers ruled out mastectomy as a risk factor for local relapse.

"In view of the recent pitfalls in the treatment of cancer-associated anemia, the use of erythropoiesis-stimulating agents can hardly be recommended as a viable treatment option," the authors write. "Molecular targets associated with tumor hypoxia and distinct from erythropoiesis merit further experimental and clinical investigation."

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