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Rheumatic symptoms following adjuvant therapy for breast cancer

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By Warner E, Keshavjee al-N, Shupak R, Bellini A • www.ProHealth.com • June 10, 1997


Twenty-three women with a diagnosis of breast cancer who
subsequently developed new nonmetastatic rheumatic symptoms,
and/or had a history of rheumatic symptoms prior to their
diagnosis of breast cancer, were identified from the oncology
and rheumatology practices of a 400-bed tertiary-care teaching
hospital. For each patient a structured telephone interview
and detailed chart review were conducted. Of eight women with
no previous rheumatic history (Group I), four developed
polyarthritis (1 seropositive), three fibromyalgia, and one
spondylosis after the diagnosis of breast cancer, which in
four cases occurred during or shortly after
cyclophosphamide-based combination chemotherapy, in two cases
during tamoxifen therapy, and in one case after radiotherapy
only. Of 15 women who had previous rheumatic symptoms (Group
II), 12 developed worse and/or new symptoms, five after
chemotherapy and seven on tamoxifen. In both groups the
symptoms had a significant negative impact on functional
status, and in some cases resolution was only partial even
after many years of followup. Prospective studies are needed
to determine the incidence, risk factors, and optimal
management of nondestructive polyarthropathy or fibromyalgia
in women who receive systemic adjuvant therapy for breast
cancer.




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