101. Arterial thrombosis associated with adjuvant chemotherapy for breast carcinoma: a cancer and leukemia Group B study
- Author
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Wall, James G., Weiss, Raymond B., Norton, Larry, Perloff, Marjorie, Rice, Mary A., Korzun, Ann H., and Wood, William C.
- Subjects
Thrombosis -- Causes of ,Cerebral embolism and thrombosis -- Causes of ,Chemotherapy -- Complications ,Breast cancer ,Health ,Health care industry - Abstract
PURPOSE: Multiagent chemotherapy and chemohormonal therapy for breast cancer are associated with an increased risk for venous thromboembolic complications. We observed instances of arterial thrombosis in two studies of breast cancer involving multiagent chemotherapy for stages II and III disease. Our purpose in this study was to determine the incidence of this complication and whether it appeared to be related to the chemotherapy or was a random event. PATIENTS AND METHODS: Episodes of arterial thrombotic events were identified from record reviews of 1,014 assessable patients with breast cancer entered on two Cancer and Leukemia Group B protocols. Details of the kind of arterial event, when it occurred, the outcome, and the occurence of metastases were analyzed. RESULTS: Thirteen (1.3%) patients had an arterial thrombosis: six (5.3%) of 113 patients with state II disease and seven (0.8%) of 901 patients with state II disease. Four of these patients had a peripheral arterial thrombosis and nine had strokes (four were fatal). All these events occurred while the patients were receiving adjuvant chemotherapy. Only one additional arterial event (a stroke approximately four years later) has occurred in this patient group after chemotherapy was completed. CONCLUSION: Arterial thrombosis is also associated with multiagent chemotherapy in patients with breast cancer. The mechanism is unknown., Blockage of the arteries by clots, or arterial thrombosis, has been observed with increasing frequency in women receiving chemotherapy for breast cancer. The incidence of venous thrombosis during chemotherapy has already been established. To determine the incidence of arterial thrombotic events and whether or not they are related to chemotherapy, 1,014 women receiving these treatments were monitored. This group included 113 women with clinical stage III breast cancer and 901 women with stage II breast cancer and lymph node involvement. Of the stage II group, seven patients (eight percent) experienced a thrombotic event; four were peripheral thromboses (clots in a leg artery) and three were cerebral thromboses (strokes). Six of the stage III patients (six percent) experienced a stroke. The incidence of arterial thromboses in this group of chemotherapy patients is higher than would occur in a similar group of women with or without cancer. This conclusion is based on a statistical analysis of the frequency of arterial thrombosis in patients at several major medical centers. Chemotherapy for breast cancer is associated with an increased risk of arterial thrombosis, but the mechanism of this event is not known.
- Published
- 1989