Herpes Zoster in Breast Cancer Patients after Radiotherapy

Dunst, Jürgen; Steil, Bettina; Furch, Steffi; Fach, Annette; Bormann, Gisela; Marsch, Wolfgang Ch.

doi:10.1007/pl00002318

Cited by 30 publications

(25 citation statements)

References 14 publications

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“…The literature on the risk of HZ among patients with solid tumor malignancies is quite limited, especially for patients diagnosed in recent years (25)(26)(27)(28)(29)(30)(31)(32)(33)(34). The reported percentage developing HZ has ranged from approximately 1.5% to 12%.…”

Section: Discussionmentioning

confidence: 99%

The Epidemiology of Herpes Zoster in Patients with Newly Diagnosed Cancer

Habel

Ray

Silverberg

et al. 2013

Cancer Epidemiology, Biomarkers &Amp; Prevention

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Background: Given the limited literature, we conducted a study to examine the epidemiology of herpes zoster (HZ) among newly diagnosed cancer patients.Methods: We identified adult health plan members of Kaiser Permanente Northern California diagnosed with invasive cancer from 2001 to 2005. Electronic health records with inpatient and outpatient diagnoses, laboratory tests, and antiviral medications were used to identify HZ diagnoses from 2001 to 2006. HZ diagnoses and associated complications were confirmed by medical chart review. Treatment with chemotherapy and corticosteroids was used to classify patients by immunosuppression level.Results: Among 14,670 cancer patients, 424 were diagnosed with HZ during follow-up (median 22 months). The incidence of HZ was 31/1,000 person-year (PY) in patients with hematologic malignancies and 12/1,000 PY in patients with solid tumors. The corresponding 2-year cumulative incidence of HZ was approximately 6% and 2%, respectively. Compared with incidence rates of HZ reported in a general US population, the age-and sex-standardized rates of HZ were 4.8 times higher [95% confidence interval (CI), 4.0-5.6] in patients with hematologic malignancies and 1.9 times higher (95% CI, 1.7-2.1) in those with solid tumors. HZ risk increased with increasing level of immunosuppression. Among HZ cases, 19% with hematologic malignancies and 14% with solid tumors had HZ-associated pain for at least 30 days. The corresponding numbers for nonpain-related complications were 30% and 18%, respectively.Conclusions: Cancer patients are at substantially increased risk of HZ and among those with HZ, complications are relatively common.Impact: Better HZ prevention and treatment options for cancer patients are needed. Cancer Epidemiol Biomarkers Prev; 22(1); 82-90. Ó2012 AACR.

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Section: Discussionmentioning

confidence: 99%

The Epidemiology of Herpes Zoster in Patients with Newly Diagnosed Cancer

Habel

Ray

Silverberg

et al. 2013

Cancer Epidemiology, Biomarkers &Amp; Prevention

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“…Table 1 summarizes the main characteristics of the patient population with regard to major prognostic factors. Data on the frequency of herpes zoster after radiotherapy in this patient population have been published recently in this journal [5].…”

Section: Methodsmentioning

confidence: 99%

Prognostic Significance of Local Recurrence in Breast Cancer after Postmastectomy Radiotherapy

et al. 2001

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Local recurrence after treatment of breast cancer with mastectomy + radiotherapy +/- systemic therapy is associated with a significantly higher risk of distant metastases and death. In this analysis, local recurrence was a strong and, besides lymph node status and T category, an independent risk factor for survival. Minimizing the risk of local recurrence is therefore an essential goal of a curative treatment concept.

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“…Godfrey et al (2006) reported a patient who developed shingles with the surgical incision site of a thoracic surgery for scoliosis 10 , and Choi et al (2012) published a case report of a patient who developed herpes zoster within the scar of a recent facial operation. 12 Other procedures previously described to incite shingles include radiotherapy, 21 liver biopsy, 3 axillary nerve block, 22 botulinum toxin injections, 23 intra-articular injections, cryosurgery, 24 spinal surgery, 1 intubation, 25 shiatsu massage, 26 liposuction, 27 corticosteroid injections, 28 and skin grafting. 29 The pathophysiology behind reactivation of the virus has been postulated to be related to hyperemia, ganglia irritation from direct pressure, or the release of inflammatory mediators.…”

Section: Discussionmentioning

confidence: 99%

“…11 Thomas et al (2004) published a case-control study showing elevated risks of shingles for a month following trauma; 39 another study showed an elevated risk for two years following radiotherapy for breast cancer. 21 The goals for treating shingles are to lessen the duration of the patient's symptoms, to decrease the risk of transmission, and to prevent post-herpetic neuralgia. Post-herpetic neuralgia is a syndrome of cutaneous hypersensitivity and neuropathic pain that develops in roughly 10% to 15% of patients and is particularly difficult to treat.…”

Section: Discussionmentioning

confidence: 99%

Herpes Zoster Overlying Recently Placed Central Venous Access Site: A Case Report

Hess

Gunnerson

Kahler

2016

CJEM

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Herpes zoster, commonly called shingles, is a disease that results from the reactivation of varicella zoster virus. Local trauma has been reported as a precipitant for reactivation, but this condition is rarely seen localized to a fresh surgical incision. We present the case of a patient who developed shingles overlying the incision site of a recently buried central venous access port, illustrating the need to consider this diagnosis as a unique imposter of localized infection or reaction at sites of recent procedural trauma. RÉSUMÉ L'herpès zoster, communément appelé zona, est une maladie qui résulte de la réactivation du virus varicellezona. La documentation fait déjà mention de traumas locaux comme facteur précipitant de réactivation, mais le phénomène s'observe rarement au siège d'une incision chirurgicale récente. Sera décrit ici un cas de zona au point d'entrée d'un cathéter veineux central installé depuis peu, ce qui montre la nécessité d'envisager le diagnostic comme seul déclencheur d'infection localisée ou de réaction à des sièges d'intervention récente.

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Herpes Zoster in Breast Cancer Patients after Radiotherapy

Cited by 30 publications

References 14 publications

The Epidemiology of Herpes Zoster in Patients with Newly Diagnosed Cancer

The Epidemiology of Herpes Zoster in Patients with Newly Diagnosed Cancer

Prognostic Significance of Local Recurrence in Breast Cancer after Postmastectomy Radiotherapy

Herpes Zoster Overlying Recently Placed Central Venous Access Site: A Case Report

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