[Febrile neutropenia in patients with breast cancer submitted to chemotherapy: a 12-year experience].
OBJECTIVE
To identify the characteristics of patients with breast cancer who developed febrile neutropenia and to establish risk factors for its incidence and parameters for an unfavorable evolution.


METHODS
A case-control study was performed and included 65 patients: 13 patients presented febrile neutropenia and four controls per case matched by: date and number of previous chemotherapy cycles, drugs and doses used. The clinical and laboratory data were obtained from medical records. We utilized the odds ratio (OR) and the 95% confidence interval (CI) to estimate the significance of risk factors.


RESULTS
We identified two risk factors associated to occurrence of febrile neutropenia: use of chemotherapy within the first 24 hours post surgery (OR: 159.9 95% CI: 9.5 to 2699), and the concomitant use of chemotherapy and breast radiotherapy (OR: 108.3 95%CI: 4.9 to 2391). We did not observe a significant difference between cases and controls regarding age, body mass index, neutrophils and monocytes count prior to chemotherapy. Three patients died (23.1%), two of them were more than 60 years old, had no comorbidities, had received the first CMF within the first post surgery day and had surgical site infection.


CONCLUSIONS
The main risk factors associated with febrile neutropenia in patients with breast cancer were: chemotherapy within the first 24 hours post surgery, and concomitant chemotherapy and breast radiotherapy. As such, our study shows that these situations must be avoided.
Poli Neto
Omero Benedicto
OB
Hospital das Clínicas, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP.
Reis
Francisco José Candido dos
FJ
Lopes
Fernando Muniz
FM
Carrara
Hélio Humberto Angotti
HH
Andrade
Jurandyr Moreira de
JM
D000328:Adult; D000367:Age Factors; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects*; D015992:Body Mass Index; D001943:Breast Neoplasms / Q000628:therapy*; D002277:Carcinoma / Q000628:therapy*; D003520:Cyclophosphamide / Q000009:adverse effects; D004812:Epidemiologic Methods; D005260:Female; D005334:Fever / Q000209:etiology*; D005472:Fluorouracil / Q000009:adverse effects; D006801:Humans; D008727:Methotrexate / Q000009:adverse effects; D008875:Middle Aged; D009503:Neutropenia / Q000209:etiology*; D011183:Postoperative Complications / Q000209:etiology
D003520:Cyclophosphamide; D005472:Fluorouracil; D008727:Methotrexate