Long term side effects of adjuvant chemotherapy in patients with early breast cancer
Open accessAbstract
Adjuvant systemic therapy along with screening has been key to the observed improvements in disease-free and overall survival (DFS/OS) in breast cancer. Improvements in overall survival already take into account therapy related toxicities that can result in death. However, this measure alone does not adequately capture the impact on health-related quality of life. Therefore, it is important to examine the prevalence, frequency and short/long-term impact of therapy-related toxicities, identify patients who might be at greatest risk. Ultimately decisions regarding expected therapy benefits (relative and absolute percentage improvements in DFS/OS) must be made against a background of known potential harms. For many patients with early breast cancer (EBC), their risk of recurrence is not zero but is small. At the same time, for many therapies for early stage breast cancer, the risk of serious side effects is small but is not zero. As we better understand the long-term side effects of adjuvant chemotherapy and targeted therapy, it becomes critical to integrate our growing understanding of breast cancer biology with standard high-quality histopathologic measures to better identify the patients most likely to benefit from the various options for combined multimodality therapy. Hence, we must strive against the notion of recommending adjuvant systemic chemotherapy "just in case." This article focuses on the long-term side effects of adjuvant chemotherapy in patients with EBC.
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Limited healthcare capacities must be balanced between patients who suffer from reduced quality of life due to high fear of recurrence and patients who have received aggressive therapies due to high risk of recurrence and suffer from side and late effects.
“Limited healthcare capacities must be balanced between patients who suffer from reduced quality of life due to high fear of recurrence and patients who have received aggressive therapies due to the high risk of recurrence and suffer from side and late effects [15, 20].”
From The BrEasT cancer afTER-CARE (BETTER-CARE) programme to improve breast cancer follow-up: design and feasibility study results of a cluster-randomised complex intervention trial (2024) · cites this paper as [20]
The Introduction (page unavailable) says treatment decisions should weigh recurrence risk against the risk of toxicities, and the Chronic/Late Effects section says chemotherapy can have debilitating effects on future health and quality of life. The paper does not address balancing limited healthcare capacity between patients with fear of recurrence and patients with treatment-related effects; the cited passages concern individual treatment decisions, not allocation of care. (LLM, conf=0.86)
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References 58 · Cited by 258
- Authors
- Tao, J. J., Visvanathan, K., & Wolff, A. C.
- Affiliations
- Johns Hopkins University (US)
- Corresponding author
- Wolff, Antonio C.
- Venue
- The Breast
- Publisher
- Elsevier BV
- Published
- 2015-11
- Volume
- 24
- Pages
- S149-S153
- ISSN
- 0960-9776 (ISSN-L)
- PMC
- PMC4743500
- OpenAlex
- W2157652647
- Cited by
- 258
- References
- 58
- Citations by year
- 2026: 11 · 2025: 29 · 2024: 29 · 2023: 24 · 2022: 52 · 2021: 27 · 2020: 27 · 2019: 23 · 2018: 15 · 2017: 14 · 2016: 4 · 2015: 2
- FWCI
- 1.14
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- Locations
- The Breast (publishedVersion, cc-by-nc-nd)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- BMS, Genentech
- Myriad
- Mersana
- National Cancer Institute (CA006973)
- Susan G. Komen for the Cure (SAC110053)
- Topics
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Cancer Research › Breast Cancer Treatment Studies
- Health Sciences › Medicine › Oncology › Cancer survivorship and care
- Health Sciences › Medicine › Oncology › Cancer Treatment and Pharmacology
- Keywords
- early breast cancer, adjuvant chemotherapy, late effects, treatment toxicity, health-related quality of life, targeted therapy, multimodal therapy, recurrence risk
- MeSH terms
- Amenorrhea, Antineoplastic Agents, Breast Neoplasms, Female, Humans, Leukemia, Myeloid, Menopause, Ovary, Quality of Life, Time Factors, Chemotherapy, Adjuvant, Neurotoxicity Syndromes, Cardiotoxicity
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