Impact of perioperative blood transfusion on survival among women with breast cancer.

Abstract

e21591 Background: Blood transfusion has immune-modulating effect which may affect outcome in women with breast cancer including cancer recurrence and survival. Methods: PubMed, Embase and Cochrane libraries were searched by utilizing different combinations of keywords: blood transfusion, survival, mortality and breast cancer. Inclusion criteria were: (1) English articles and (2) studies with an adult population with the diagnosis of breast cancer undergoing resection which may or may not have received blood transfusion. Four hundred and seventy studies were reviewed, 13 studies meeting inclusion criteria were pooled for Meta-analysis. Results: Twenty five datasets from 13 studies with total N = 7384 subjects (transfused 2264, not transfused 5120) were pooled. Survival rates recorded at a specified time frame, this range from 4-12 years. Major confounding factors effecting survival in this population may include age, presence of other chronic illnesses, spread of breast cancer to lymph nodes, stage of cancer and extent of cancer treatment. Type, group and number of blood units transfused may also play a role. Survival rates among not transfused group range from 34% to 79% while in transfused group range from 41% to 78%. Significant heterogeneity was detected among studies; therefore random effect model was used. Comparing women without blood transfusion, women with transfusion have Odd ratio of overall survival 0.79 (0.72 to 0.86, I2= 47.3, P = 0.001). we also performed sensitivity and subgroup analysis. Conclusions: Perioperative blood transfusion appears to adversely impact survival among women with breast cancer

Neoadjuvant chemotherapy is associated with a high rate of perioperative blood transfusion at the time of interval cytoreductive surgery

“…Patients receiving blood product transfusion face risks including infectious, allergic reactions, non-allergic immune reactions, and volume overload. Data from other patient populations suggests that allogeneic blood product transfusion may be associated with poorer oncologic outcomes [3][4][5][6][7]. This has been demonstrated in advanced ovarian cancer patients undergoing primary cytoreduction surgery for stage III disease where transfusion was associated with a shortened median time to progression or survival of 6 months and 22 months, respectively [8].…”

“…Blood transfusion has been scrutinized in intensive care and trauma settings, as it is consistently associated with worse outcomes [1,2]. In cancer patients, perioperative blood transfusions have been shown to worsen survival in colorectal, breast and other malignancies [3][4][5][6][7]. These findings have been inconsistently replicated in patients with ovarian cancer [8,9] but limited research in this area has been published.…”

Risk factors and nursing countermeasures of postoperative pulmonary infection in patients with breast cancer

“…In addition, the drainage port is prone to bacterial invasion, which further increases the risk of postoperative pulmonary infection, prompting the clinical need to do comprehensive nursing work. [30][31][32][33] Preventive measures with improved body position, retrograde irrigation and negative pressure drainage, combined with antibacterial drugs, etc may be beneficial to reduce the onset of pulmonary infection. [34,35] Patients after radical mastectomy are prone to pulmonary infection.…”