All patients attained Tanner stage 5. In this group, there was one patient with breast cancer. The diagnosis was conducted on a 37-year-old patient during her twenty-fourth year of therapy. This patient had had a myeloblastic acute leukemia at age 12 and had been submitted to conventional chemotherapy and BMT with previous ablative chemotherapy (busulfan, cyclophosphamide) and TBI (12 Gy) as a conditioning regime. She had had one spontaneous menstrual cycle before the illness and, upon starting hormonal therapy, at age 13, she had an LH level of 49 mIU/mL and FSH of 42.9 mIU/mL (NV <15). The breast tumor was intraductal with positive receptors for E2 (85%), Prog (85%), ErbB+ and Ki67 (30%). She is alive and, after surgery and chemotherapy, has been disease-free for the past 4 years. This occurrence represents an incidence rate of 0.94/1,000 patient-years of exposure to treatment (Table 3). In this group, lumbar/femoral osteopenia was found in 20%/14% of patients and osteoporosis in 12%/7%. Treatment improvement was achieved in 38%/31% at lumbar and femoral points, respectively (Tables 4, 5, 6).
We have not found any case of breast cancer in this patient subgroup. Regarding bone density, lumbar/femoral osteopenia was found in 22%/19% and osteoporosis in 4%/1% of patients. Treatment improvement was achieved in 50%/57% at lumbar and femoral points, respectively (Tables 4, 5, 6).
One patient developed breast cancer in this subgroup. At 51 years of age, she had had a multiple myeloma and had been treated with chemotherapy. At 52 years of age, she underwent BMT with previous ablative chemotherapy (melphalan). She immediately started menopause, complaining of flushes and high gonadotropin values (LH-49.1 mIU/mL and FSH-88 mIU/mL). She was started on HRT and after 3 years, she was diagnosed with intraductal breast cancer with positive receptors E2 (100%) and ErbB+. She was submitted to surgery, radiotherapy and antiestrogen therapy and died with myeloma relapse at age 70. This patient had a family history of breast cancer (her grandmother, grandaunt and sister). This occurrence represents an incidence rate of 3.42/1,000 patients-years of exposure to treatment (Table 3). Lumbar/femoral osteopenia was found in 17%/31% and osteoporosis in 21%/7% of the patients. Treatment improvement was achieved in 64%/55% at lumbar and femoral points, respectively (Tables 4, 5, 6).
During the follow-up, 6 vascular complications were observed, 4 of which were thrombosis occurring in areas treated with radiotherapy, and the remaining 2 were leg phlebitis (Table 7). Looking at the whole sample, we can see an incidence rate of 2.63 cases per 1,000 patients-years of exposure to treatment (Table 8).