Breast cancer survival and perioperative blood transfusion.
The effect of perioperative blood transfusion on disease-free and overall survival was studied in 812 patients with stages I and II breast cancer, followed up prospectively in a multicenter study. All patients initially underwent a modified radical mastectomy. Patients with axillary node-negative, stage I cancer were followed up without additional therapy. Patients with axillary node-positive, stage II cancer were randomized to receive adjuvant chemoendocrine therapy. Transfusion was done in 35.8% of the patients with stage I and in 37.3% of the patients with stage II cancer. For the patients with stage II cancer, perioperative blood transfusion did not affect disease-free or overall survival. For the patients with stage I cancer, perioperative blood transfusion resulted in a worse disease-free and overall survival (p = 0.05 and 0.02, respectively), which was particularly evident for those patients who received more than 1 unit. This study suggests that stage of disease, adjuvant therapy, number of transfusions, and duration of follow-up must be considered in further analyses.
Crowe
J P
JP
Department of Surgery, Case Western Reserve University, Cleveland, Ohio.
Gordon
N H
NH
Fry
D E
DE
Shuck
J M
JM
Hubay
C A
CA
D000206:Actuarial Analysis; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D001365:Axilla; D001803:Blood Transfusion / Q000706:statistics & numerical data; D001943:Breast Neoplasms / Q000401:mortality* / Q000473:pathology / Q000601:surgery / Q000628:therapy; D003131:Combined Modality Therapy; D005069:Evaluation Studies as Topic; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008207:Lymphatic Metastasis; D015411:Mastectomy, Modified Radical; D015337:Multicenter Studies as Topic; D009367:Neoplasm Staging; D011379:Prognosis; D011446:Prospective Studies; D011897:Random Allocation; D013997:Time Factors; D065227:Transfusion Reaction