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Toxicity of Adjuvant Chemotherapy
Source: Breast Cancer Treatment (PDQ®)–Health Professional Version, National Cancer Institute.
Source updated: April 25, 2025 · Captured 2026-09-09.
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Context: Toxicity of Systemic Therapy
The acute toxicities of the drugs used for adjuvant chemotherapy are the same as those observed when these drugs are used in other treatment settings. However, because many patients with early breast cancer have prolonged survival, long-term adverse effects are particularly important in this setting. The following two toxicities are of special concern:
Cardiotoxicity from anthracyclines.
Marrow neoplasia. A study of 20,063 patients treated in National Comprehensive Cancer Network centers found an incidence of marrow neoplasia of 0.46 per 1,000 person-years in women treated with anthracycline- and/or cyclophosphamide-containing chemotherapy. This rate was significantly higher than the rate observed in women who were treated with surgery alone (hazard ratio, 6.8; 95% confidence interval [CI], 1.3–36.1).[9]
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