INTRODUCTION: Cytotoxic chemotherapy places all cancer patients at risk of developing myelosuppression. Different chemotherapy regimens could lead to development of neutropenia, anemia and thrombocytopenia which may lead to delays in facilitating chemotherapy and also may place cancer patients at risk of developing severe complications which may be life threatening. This study determined the incidence of neutropenia, anemia, and thrombocytopenia per cycle of chemotherapy starting after the 1st cycle among non-metastatic breast cancer patients. It also evaluated if age, size of primary tumor, number of positive lymph nodes, IHC result, BMI, co-morbidities and chemotherapy used were associated with the development of neutropenia, anemia and thrombocytopenia during the 10 cycle of chemotherapy; this may help in ascertaining which patients may need more intensive monitoring during subsequent chemotherapy sessions.
METHODS: This is a time series study wherein the CBC results starting prior 1° chemotherapy cycle were gathered from medical charts of non-metastatic breast cancer patients receiving cyclophosphamide/ doxorubicin/ docetaxel/ fluororuracil chemotherapy at UP-PGH and JRRMMC Medical Oncology Clinics enrolled under the DOH-NCPAM BCMAP program, from 1 January 2009 to 31 June 2014. Incidence rates of neutropenia, anemia and thrombocytopenia were recorded per cycle of chemotherapy. Severity of myelosuppression was graded based on the Common Toxicity Criteria of the National Cancer Institute Version 2.0. Possible predictors of myelosuppression were assessed focusing on the 1st cycle of chemotherapy where interventions were not yet done. Standard statistical methods were used for the descriptive analysis. Variables were analyzed using the Chi square test and logistic regression; level of significance was at p<0.05.RESULTS: 751 patients were included in the study, who had a total of 3,759 CBC results. The incidence of neutropenia, anemia, thrombocytopenia for all 3,759 CBC results were 3%, 2.3%, and 0.5%, respectively. Among all recorded CBC results only 0.9% had grade 3-4 neutropenia and 0.3% grade 3-4 anemia. There was no severe thrombocytopenia.
After the 1st chemotherapy cycle, the incidence of neutropenia was 4.67% (35 patients), anemia 2.27% (17 patients), and thrombocytopenia 0.8% (6 patients). Of these patients, only 1.17% (9 patients) experienced severe neutropenia and 0.27% (2 patients) experienced grade 3-4 anemia. No patient experienced grade 3-4 thrombocytopenia.
Age, size of primary tumor, number of positive lymph nodes, IHC result, BMI, co-morbidities and chemotherapy used were not associated with risk for myelosuppression during the 1st cycle of chemotherappy.
CONCLUSION: Incidence rates of neutropenia, anemia and thrombocytopenia were minimal in non-metastatic breast cancer patients undergoing cytotoxic chemotherapy, with low rates of severe myelosupression. Myelosupression from standard doxorubicin/ cyclophosphamide/ docetaxel/ fluoracil containing chemotherapy regimens can be given to non-metastatic breast cancer patients, completing required number of chemotherapy cycles with nil interruption or delay.

Human ; Male ; Female ; Breast ; Breast Neoplasms ; Neutropenia ; Anemia ; Thrombocytopenia ; Incidence ; Cyclophosphamide ; Drug Therapy

INTRODUCTION: Sexual function is an important aspect of quality of life, and can be drastically affected in ill patients. Very few studies (and apparently none among Filipinas) looked into sexual dysfunction among females with breast cancer (BrCa); prevalence also is not well defined. This study evaluates the prevalence of sexual dysfunction among Filipino patients with BrCa, and assesses which treatment or if duration of illness, age, BMI, smoking history, diabetes, hypertension significantly contributed to the dysfunction.
METHODS: A cross sectional study was conducted among BrCa patients consulting at the outpatient medical oncology clinic of a government tertiary hospital. Study population included those diagnosed and was with breast cancer over a 3-months period, with a calculated sample size of 60 (within 81±10% prevalence rate, Cl 95%). A validated translated version of the Female Sexual Function Index (FSFI) 19-item questionnaire that looked into 6 domains (arousal, lubrication, desire, pain, orgasm, and satisfaction) was used. Sexual dysfunction was defined as an FSFI score of <26.55.
RESULTS: Of the 97 respondents, mean age was 49.4 years old and mean BMI of 24.8. About 78% received chemotherapy, 26% hormonal therapy. 15% radiotherapy, 82% modified radical mastectomy (MRM), and 71% received both MRM and chemotherapy at the time of interview. Duration of cancer was
months in 72% of subjects. There were 97.9% who had sexual dysfunction which is similar to prevalence rates (64-98%) in other studies. Age, BMI, smoking history, hypertension, diabetes mellitus, chemotherapy, surgery, hormonal therapy, radiation therapy, and duration of illness were shown not to be significant predictors of sexual dysfunction among Filipinas with BrCa by bivariate analysis.
CONCLUSION: Sexual dysfunction is highly prevalent among female Filipino BrCa patients. Knowing such high prevalence should prompt health care providers to include interventions to improve quality of life of BrCa patients, including their sexual life.

Human ; Female ; Middle Aged ; Adult ; Quality Of Life ; Breast Neoplasms ; Prevalence ; Body Mass Index ; Smoking ; Diabetes Mellitus ; Hypertension ; Medical Oncology ; Orgasm ; Arousal ; Lubrication ; Mastectomy