CLINICAL, PARACLINICAL FEATURES, OUTCOMES, AND ASSOCIATED FACTORS OF DOSE-DENSE 4AC–4P ADJUVANT CHEMOTHERAPY IN HIGH-RISK BREAST CANCER
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Abstract
Background: Breast cancer is a common malignant disease, with an increasing incidence rate, and it poses a significant burden on public health. Dose-dense regimens represent a breakthrough in the management of high-risk breast cancer, optimizing treatment intensity, thereby improving survival and effectively reducing recurrence. Objectives: To describe the clinical and paraclinical characteristics and evaluate factors associated with chemotherapy outcomes in patients with high-risk breast cancer treated with dose-dense 4AC–4P adjuvant chemotherapy. Materials and methods: A cross-sectional descriptive study was conducted on 78 patients diagnosed with breast cancer who received dose-dense 4AC–4P adjuvant chemotherapy at Can Tho Oncology Hospital from May 2024 to January 2026. Results: The mean age in the study was 47.79 ± 7.33 years, with the 41–50 age group accounting for the majority (47.4%). The ≤ 40-year-old group had a higher rate of family history of related diseases compared with the >40-year-old group, and the association was statistically significant (OR = 6.9; KTC 95%: 4.000–11.934; p = 0.026). Patients with a history of chronic diseases had a higher rate of vomiting compared with those without (37.5% versus 17.4%), and the association was statistically significant (OR = 2.85; 95% CI: 1.002–8.109; p = 0.045). Conclusion: A family history of breast cancer is a major risk factor in younger patients, indicating the need for genetic counseling at the time of diagnosis. Chemotherapy-related vomiting is increased in patients with concomitant chronic diseases and requires more thorough evaluation and control in this population.
Keywords
Breast cancer, chemotherapy, dose-dense, high risk
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References
2. Ando K., Shimomura A. Optimizing the adjuvant chemotherapy for HER2-positive early breast cancer. AME Clin Trials Rev. 2025. 3,56, doi:10.21037/actr-24-251.
3. Brandberg Y., Johansson H., Hellström M., Gnant M., Mobus V., et al. Long-term (up to 16 months) health-related quality of life after adjuvant tailored dose-dense chemotherapy vs. standard three-weekly chemotherapy in women with high-risk early breast cancer. Breast Cancer Res Treat. 2020. 181, 87–96, doi: 10.1007/s10549-020-05602-9.
4. Gray R., Bradley R., Braybrooke J., Liu Z., Peto R., et al. Increasing the dose intensity of chemotherapy by more frequent administration or sequential scheduling: A patient-level metaanalysis of 37,298 women with early breast cancer in 26 randomised trials. Lancet. 2019. 393(10179), 1440–1452, doi: 10.1016/S0140-6736(18)33137-4.
5. Phạm Tuấn Anh, Trần Văn Thuấn, Lê Thanh Đức, Nguyễn Tiến Quang. Đánh giá hiệu quả bước đầu và tính an toàn của phác đồ hóa trị 4AC-4P liều dày trong điều trị bổ trợ ung thư vú. Tạp chí Ung thư học Việt Nam. 2019. (4), 222–228.
6. Đỗ Thị Kim Anh. Đánh giá kết quả điều trị hóa chất bổ trợ phác đồ 4AC-4Paclitaxel trên bệnh nhân ung thư vú giai đoạn II–III. Tạp chí Ung thư học Việt Nam. 2008. 1, 260–266.
7. Citron M.L., Berry D.A., Cirrincione C., Hudis C., Winer E.P., et al. Randomized trial of dosedense versus conventionally scheduled and sequential versus concurrent combination chemotherapy as postoperative adjuvant treatment of node-positive primary breast cancer: first report of Intergroup Trial C9741/Cancer and Leukemia Group B Trial 9741. J Clin Oncol. 2003. 21(8), 1431–1439, doi:10.1200/JCO.2003.09.081.
8. Kummel S., Krocker J., Kohls A., Breitbach G., Morack G., et al. Randomized trial: survival benefit and safety of adjuvant dose-dense chemotherapy for node-positive breast cancer. Br J Cancer. 2006. 94, 1237–1244.
9. Mavaddat N., Peock S., Frost D., Ellis S., Platte R., et al. Cancer risks for BRCA1 and BRCA2 mutation carriers: results from prospective analysis of EMBRACE. J Natl Cancer Inst. 2013. 105(11), 812–822, doi:10.1093/jnci/djt095.
10. Phùng Thị Huyền. Đánh giá kết quả hóa trị bổ trợ kết hợp Trastuzumab trên bệnh nhân ung thư vú giai đoạn II, III. Luận án Tiến sĩ. Đại học Y Hà Nội. 2016. 116.
11. Swain S.M., Tang G., Geyer C.E. Jr., Rastogi P., Atkins J.N., et al. Definitive results of a phase III adjuvant trial comparing three chemotherapy regimens in women with operable, nodepositive breast cancer: the NSABP B-38 trial. J Clin Oncol. 2013. 31, 3197–3204, doi: 10.1200/JCO.2012.48.1275.
12. Moebus V., Jackisch C., Lueck H.J., Bois A., Thomssen C., et al. Intense dose-dense sequential chemotherapy with epirubicin, paclitaxel, and cyclophosphamide compared with conventionally scheduled chemotherapy in high-risk primary breast cancer: Mature results of an AGO phase III study. J Clin Oncol. 2010. 28, 2874–2880, doi: 10.1200/JCO.2009.24.7643.
13. Jiang T., Wang X., Zheng L., Ren T., Li Y., et al. Risk factors of nausea and vomiting in patients with breast cancer undergoing chemotherapy: A retrospective study. Medicine. 2025. 104(3), e41067, doi: 10.1097/MD.0000000000041067.