Abstract
Introduction: Breast cancer is the most frequently diagnosed cancer among the women. Most commonly
used chemotherapy regimen is Doxorubicin and Cyclophosphamide (AC) which carries significant
risk of febrile neutropenia. The aim of the study is to identify the incidence of
febrile neutropenia and its effects on the delivery of chemotherapy in patients receiving
following AC chemoregimen without primary prophylaxis. Materials and Methods: We retrospectively analyzed the case records of the localized breast cancer patients
who were treated with AC chemoregimen without primary prophylaxis for febrile neutropenia.
Results: Between 2013 and 2017, a total of 231 cases received AC chemoregimen. A total of
14 (6.1%) patients were found to have febrile neutropenia. All patients were recovered
by day 19 and no deaths were observed. Except for ECOG performance status (P = 0.001) no significant association was found with age, co-morbidities, menopausal
status, body surface area and stage of the cancer. There were no treatment delays
or dose reductions because of febrile neutropenia. Conclusion: The incidence of FN with AC chemotherapy in breast cancer patients is relatively
less in the present study. Routine primary prophylaxis is not recommended as this
chemotherapy falls in to low risk category for FN but can be considered for patients
with ECOG PS > 1. If the diagnosis of febrile neutropenia and institution of appropriate
measures are prompt, FN did not affect the delivery of chemotherapy and thus compromise
survival.
Key words
Doxorubicin and cyclophosphamide chemotherapy - febrile neutropenia - prophylaxis