title: Herpes infections in breast cancer patients treated with adjuvant chemotherapy.
abstract: OBJECTIVE
  There is little information on Herpes zoster infection in breast cancer patients as a complication during adjuvant chemotherapy. The aim of this study is to evaluate the incidence of Herpes zoster and simplex infections in this patients setting.
  
  
  METHODS
  We analyzed 623 early-stage breast cancer patients in our Institute over a period of 7 years (1998-2005). Four-hundred and sixty-one patients were treated with anthracycline-based chemotherapy, 116 with CMF and 46 with taxane-containing regimens.
  
  
  RESULTS
  Twelve (1.9%) developed herpes zoster; 9 patients, receiving anthracycline-based chemotherapy, two taxane-containing regimens, and one CMF regimen. Herpes zoster infection required treatment delay in 6 patients. Adjuvant chemotherapy was delayed for 1 week in 2 patients, while in 4 patients with more severe symptoms chemotherapy was delayed for 2 weeks. One patient, despite i.v. acyclovir, had severe postherpetic motor neuropathy with a permanent ambulation impairment, and chemotherapy was stopped. In our study, herpes zoster occurred in 55/1,000 cases/year. The reported incidence in the general population varies between 2.2 and 4.1 per 1,000 patients/year; therefore, the risk of developing herpes zoster in these patients may be 13- to 25-fold higher compared to the incidence in the general population. In addition, 13 of 623 patients developed herpes simplex.
  
  
  CONCLUSIONS
  Our findings suggest that adjuvant chemotherapy can facilitate reactivation of herpes infection.
authors.affiliation: Department of Medical Oncology and Hematology, Istituto Clinico Humanitas, Milan, Italy. giovanna.masci@humanitas.it
authors.forename: Giovanna
authors.initials: G
authors.lastname: Masci
authors.forename: Massimo
authors.initials: M
authors.lastname: Magagnoli
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Gullo
authors.forename: Emanuela
authors.initials: E
authors.lastname: Morenghi
authors.forename: Isabella
authors.initials: I
authors.lastname: Garassino
authors.forename: Matteo
authors.initials: M
authors.lastname: Simonelli
authors.forename: Armando
authors.initials: A
authors.lastname: Santoro
mesh_terms: D000328:Adult; D000368:Aged; D018943:Anthracyclines; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D001943:Breast Neoplasms / Q000188:drug therapy* / Q000821:virology*; D018567:Breast Neoplasms, Male / Q000188:drug therapy / Q000821:virology; D017024:Chemotherapy, Adjuvant; D005260:Female; D006561:Herpes Simplex / Q000150:complications / Q000453:epidemiology; D006562:Herpes Zoster / Q000150:complications / Q000453:epidemiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D043823:Taxoids
chemical_list: D018943:Anthracyclines; D043823:Taxoids