Increased incidence of myelodysplastic syndrome and acute myeloid leukemia following breast cancer treatment with radiation alone or combined with chemotherapy: a registry cohort analysis 1990-2005
2011

Increased Risk of Blood Disorders After Breast Cancer Treatment

Sample size: 5790 publication 10 minutes Evidence: moderate

Author Information

Author(s): Henry G Kaplan, Judith A Malmgren, Mary K Atwood

Primary Institution: Swedish Cancer Institute at Swedish Medical Center, Seattle, WA, USA

Hypothesis

What is the risk of myelodysplastic syndrome (MDS) and acute myeloid leukemia (AML) associated with radiation and/or chemotherapy in breast cancer patients?

Conclusion

Breast cancer patients under 65 who received radiation or combined radiation and chemotherapy have a significantly elevated risk of developing MDS and AML.

Supporting Evidence

  • 17 cases of MDS/AML were observed during the follow-up period.
  • The rate of MDS in patients under 65 was 10.88 times higher than expected.
  • The rate of AML in patients under 65 was 5.32 times higher than expected.
  • No significant increased risk of MDS or AML was observed in women aged 65 or older.

Takeaway

This study found that younger breast cancer patients who had radiation treatment are more likely to get serious blood disorders later on.

Methodology

The study analyzed breast cancer patients treated from 1990 to 2005, tracking their health for blood disorders over an average of 7.17 years.

Potential Biases

Potential underreporting of MDS due to its recent classification as a reportable cancer.

Limitations

The study lacked cytogenetic studies for all patients, which could confirm treatment-related leukemia.

Participant Demographics

Average age was 57 years, with 69% under 65 and 31% 65 or older.

Statistical Information

P-Value

p<0.001

Confidence Interval

95% CI = .17, .47

Statistical Significance

p<0.05

Digital Object Identifier (DOI)

10.1186/1471-2407-11-260

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