Short-term outcome of chronic immunosuppression on the development of breast lesions in premenopausal heart and lung transplant patients

Anne Campbell, Nader Moazami, Beth Ann Ditkoff, Ellen Kurtz, Alison Estabrook, Freya Schnabel

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12 Scopus citations

Abstract

The risk of development of breast lesions in patients on chronic immunosuppression is unknown. In order to assess this risk, a retrospective review was performed of the records of 87 women between the ages of 12 and 47 years who received thoracic organ transplant from 1987 to 1996 at our institution. Inclusion criteria consisted of patients who were premenopausal, had no previous history of breast disease, and survived for at least 1 year posttransplantation. All patients were on a triple immunosuppressive regimen consisting of cyclosporine, steroids, and azathioprine. Mean follow-up was 4 ± 1.2 years with a range of 1-6 years. During this period, 21 patients (24%) with a mean age of 38 ± 10 years had screening or diagnostic mammography. The remainder of patients with a mean age of 24 ± 9 years were followed clinically. Overall, 10 patients (11%) developed a total of 17 palpable, solid lesions at 33 to 72 months posttransplantation. Fifteen of these lesions were surgically excised. Five of the patients had multiple lesions. Pathological examination of the specimens revealed fibroadenoma in nine, fibrocystic disease in four, low grade phylloides tumor in one, and T-cell lymphoma in one case. None of the patients have developed primary breast cancer during follow-up. In conclusion, short-term immunosuppression does not increase the risk of the development of benign breast lesions in young women after thoracic organ transplantation, but rather the distribution of benign lesions is similar in an age-matched population. There were several cases of multiple fibroadenomas in the transplant population, but mammography revealed no malignant disease in this age group and does not need to be utilized in this population beyond what is considered standard for immunocompetent patients. The long-term effect of immunosuppressive therapy on the development of breast cancer in this group remains to be defined.

Original languageEnglish
Pages (from-to)27-30
Number of pages4
JournalJournal of Surgical Research
Volume78
Issue number1
DOIs
StatePublished - 15 Jul 1998
Externally publishedYes

Keywords

  • Benign breast disease
  • Fibroadenoma
  • Immunosuppression
  • Thoracic transplantation

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