By Dr. Hanadi Bu-Ali, Breast Surgeon, Wheaton Franciscan Comprehensive Breast Care Program in Wauwatosa, WI.
Myelodysplastic syndromes (MDS) are not unheard of in breast cancer patients who have undergone treatment for their cancer. I am sure many of us have heard Good Morning America Host Robin Roberts’ announcement this week that after beating breast cancer 5 years ago, she has been diagnosed with MDS. However, it does not mean that every patient who is treated with chemotherapy or radiation would develop it. As a matter of fact, most would not. As a cancer survivor, you are usually under close surveillance while undergoing treatment for the condition.
MDS includes a diverse collection of blood-related medical conditions that involve ineffective production (or dysplasia) of blood cells. They are all disorders of the stem cells (originator cells) in the bone marrow — which is the spongy material inside your bones where blood cells are made. In MDS, the number and quality of blood-forming cells (stem cells) declines, irreversibly leading to ineffective production.
There are several types of MDS, depending on the kind of cells that are affected. If primarily red blood cells are affected, anemia — with symptoms of fatigue or shortness of breath — can occur. Recurrent infections occur when white blood cells are primarily affected. If it is platelets, which are cells associated with blood clotted that are primarily affected, easy bruising or bleeding might occur. Symptoms might not be present early on in the disease.
Most often, the cause of the changes to the bone marrow is unknown. This is called de novo MDS. However, MDS can be caused by exposure to chemotherapy and radiation, which are common cancer treatments. This is called "treatment-related MDS." To differentiate MDS from other diseases that affect the formation of blood cells, a bone marrow sample is needed.
If you have been out of treatment for several years and are not being as closely followed, please look for the symptoms listed above and report them to your physician.
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