Abstract
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. 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. 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. 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.
Highlights
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
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
Summary
OMERO BENEDICTO POLI NETO, FRANCISCO JOSÉ CANDIDO DOS REIS*, FERNANDO MUNIZ LOPES, HÉLIO HUMBERTO ANGOTTI CARRARA, JURANDYR MOREIRA DE ANDRADE. Identificar as características das pacientes com câncer de mama que desenvolveram neutropenia febril, estabelecer fatores de risco para a sua ocorrência e indicadores de evolução desfavorável. Os principais fatores de risco associados a neutropenia febril em pacientes com câncer de mama foram quimioterapia nas primeiras 24 horas após a cirurgia, e uso concomitante de quimioterapia e radioterapia da mama. O objetivo deste estudo foi identificar as características das pacientes com câncer de mama que desenvolveram neutropenia febril após quimioterapia, e estabelecer fatores de risco para a sua ocorrência e indicadores de evolução desfavorável. Observamos dois fatores de risco associados à evolução para neutropenia febril: a realização de quimioterapia dentro das primeiras 24 horas após a cirurgia (OR: 159,9 IC 95%: 9,5 a 2699) e a realização concomitante de quimioterapia e radioterapia da mama (OR: 108,3 IC 95%: 4,9 a 2391) (Tabela 2). Apenas uma paciente tinha alto risco para complicações com escore de risco inferior a 21
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