title: Long-term toxic effects of adjuvant chemotherapy in breast cancer.
abstract: Breast cancer is the most common malignant tumor affecting women. Adjuvant systemic therapies have been shown to have a significant impact on reducing the risk for breast cancer recurrence and overall mortality. Chemotherapy remains an important and frequently used treatment option in the adjuvant setting, and the associated short-term adverse events are very well described. However, there is insufficient information regarding the long-term sequelae of most chemotherapeutic agents. In this review, we describe different potential long-term adverse events associated with adjuvant chemotherapy in breast cancer, with a particular focus on long-term cardiac toxicity, secondary leukemia, cognitive function, and neurotoxicity. In addition, we discuss the effect of adjuvant chemotherapy on fertility and sexual function of young breast cancer patients. These adverse events are frequently overshadowed by the well-demonstrated clinical efficacy and/or reassuring short-term safety profiles of the different chemotherapy regimens commonly used today. We believe that a proper understanding and appreciation of these adverse events will enable us to refine our strategies for managing breast cancer. The fact that adjuvant chemotherapy is often given to patients who might not really need it urges us to consider the whole spectrum of chemotherapy risks versus benefits to maximize benefit without compromising quality of life.
authors.affiliation: Department of Medical Oncology, Jules Bordet Institute, Brussels, Belgium.
authors.forename: H A
authors.initials: HA
authors.lastname: Azim
authors.affiliation: Department of Medical Oncology, Jules Bordet Institute, Brussels, Belgium.
authors.forename: E
authors.initials: E
authors.lastname: de Azambuja
authors.affiliation: Department of Oncology, Terni Hospital, Terni, Italy.
authors.forename: M
authors.initials: M
authors.lastname: Colozza
authors.affiliation: Department of Clinical Oncology, University Hospital of Clementino Fraga Filho, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil.
authors.forename: J
authors.initials: J
authors.lastname: Bines
authors.affiliation: Department of Medical Oncology, Jules Bordet Institute, Brussels, Belgium. Electronic address: martine.piccart@bordet.be.
authors.forename: M J
authors.initials: MJ
authors.lastname: Piccart
mesh_terms: D000970:Antineoplastic Agents / Q000009:adverse effects*; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects*; D001943:Breast Neoplasms / Q000188:drug therapy*; D059186:Chemoradiotherapy, Adjuvant / Q000009:adverse effects; D005260:Female; D006801:Humans
chemical_list: D000970:Antineoplastic Agents