A single-institution chart review of breast cancer patients treated with adjuvant chemotherapy
Bibliographic record
Abstract
ABSt RACt Rationale: Many of the immediate effects of chemotherapy are widely known, but the late effects postchemotherapy have not been extensively described. The purpose of this study was to determine the statistical occurrence of postchemotherapy arthralgia (PCA) in breast cancer patients in a single institution. The study further attempted to determine if certain chemotherapy regimes, comorbidities or menopausal status correlate with PCA symptoms. Methods: This retrospective chart review included all patients from the Dr. H. Bliss Murphy Cancer Centre with Stage I, II or III breast cancer who received adjuvant chemotherapy during the 2005 calendar year. Information collected included the incidence of reported PCA and correlating factors. Results: A total of 56 charts were eligible for the study, with 51 satisfying the inclusion criteria. Of the eligible charts, 18 (35.3%) reported PCA and 33 (64.7%) did not report PCA. Of the charts reporting PCA, 5 cases (27.8%) were recorded at ≤ 8 weeks postchemotherapy, and 10 (55.5%) between 8 weeks and 16 weeks, inclusive. The remaining 3 charts (16.7%) reported PCA at ≥ 16 weeks. Within the PCA group, 5 patients (27.8%) were treated with fluorouracil + epirubicin + cyclophosphamide (FEC100) for a total of 6 cycles. Five patients (27.8%) were treated with 3 cycles of FEC100 plus 3 cycles of docetaxel. Four cases (22.2%) received 6 cycles of docetaxel + doxorubicin + cyclophosphamide (TAC) and 3 (16.7%) were given 4 cycles of doxorubicin + cyclophosphamide (AC). The remaining patient (5.5%) was treated with dose-dense epirubicin + cyclophosphamide (EC) for 6 cycles plus 4 cycles of paclitaxel. Of the 18 patients in the PCA group, 10 (55.5%) were premenopausal and 8 (44.5%) were postmenopausal prior to chemotherapy. Of the 10 premenopausal PCA patients, 6 (60%) were reported as having become postmenopausal following chemotherapy. Eleven patients (61.1%) in the PCA group were estrogen and/or progesterone receptor (ER/PR)-positive. Of these positive patients, 7 (63.6%) were treated with tamoxifen and 4 (36.4%) received an aromatase inhibitor (AI). Seven (38.9%) patients in the PCA group were ER/PR-negative. Conclusions: Our findings have highlighted that PCA is a common, unpleasant postchemotherapy event for a large proportion of breast cancer patients. It would be beneficial for physicians to inquire about symptoms of PCA and document the details in the patient chart. Furthermore, prospective studies should include specific questions such as character, onset, severity and treatment to help define the typical pattern of PCA. Such information could be used to diagnose this side effect and potentially help differentiate between PCA and onset of metastatic disease. OriginAl res eArch Canadian clinical investigations
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.005 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.003 | 0.003 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".