Anemia Triples Risk of Local Recurrence in Breast Cancer Patients

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The surgery was either a breast-conserving lumpectomy, which required additional radiation, or a modified radical mastectomy, for which radiation was optional. The radiation was given in the middle of chemotherapy treatment process, which is now an outdated method, Yee noted. "We tend not to do this kind of sandwich technique anymore," he explained.

After an average follow-up of 61 months, 39 local relapses occurred among the 424 women: 6.9 percent in patients without anemia and 19.5 percent in patients with anemia. The five-year rates of local relapse were 8.2 percent among patients without anemia and 19.6 percent among patients with anemia.

In addition to anemia, two other factors -- an older age at diagnosis and positive lymph node status -- significantly increased the risk of a local recurrence of breast cancer. According to an analysis of the range of factors examined in the study, patients with anemia had a 2.96-fold increased relative risk of a local recurrence.

Since the Austrian research was conducted, the treatment of anemia in breast cancer patients has become controversial, Lembersky noted.

"Erythropoietin-stimulating agents are indicated for use by the FDA [U.S. Food and Drug Administration] when red blood cell counts are too low," he said. "However, there is now controversy about their use due to the possible increase in tumor growth in breast cancer."

Dubsky agreed.

"I am sure you are aware of the recent pitfalls in the use of erythropoiesis-stimulating agents (ESAs)," he said. "Given this context, we should start discussing anemia more in the context of tumor hypoxia and look for targets that are distinct from erythropoiesis."

Here's more on the treatment of early-stage breast cancer.