Breeching “The Goldilocks Zone”: Tetraplegia as a Rare Life-Altering Infective Complication of Adjuvant Breast Cancer Chemotherapy Breeching “The Goldilocks Zone”

Aoife Broderick (1), Hailey Kathryn Carroll (2), Kenneth O'Riordan (3), Arthur Jackson (4), John Macfarlane (5), Seamus O'Reilly (6)
(1) Department of Medical Oncology, Cork University Hospital, Cork, Ireland, Ireland,
(2) Cork University Hospital, Department of Medical Oncology, University College Cork, Cork, Ireland, Ireland,
(3) Mercy University Hospital Cork, Department of Radiology, University College Cork, Cork, Ireland, Ireland,
(4) Cork University Hospital, Department of Infectious Diseases, University College Cork, Cork, Ireland, Ireland,
(5) Cork University Hospital, Department of Rehabilitation Medicine, University College Cork, Cork, Ireland, Ireland,
(6) Cork University Hospital, Department of Medical Oncology, University College Cork, Cork, Ireland/Cork University Hospital, Department of Rehabilitation Medicine, University College Cork, Cork, Ireland, Ireland

Abstract

Background: Adjuvant chemotherapy has been an integral component of breast cancer care for decades. Advances in supportive care have been made, but despite this, infective complications of therapy remain a significant toxicity concern.


Case Presentation: A premenopausal patient presented to the emergency department during the third wave of the Covid-19 pandemic with sepsis after a second course of adjuvant docetaxel-cyclophosphamide chemotherapy. Overnight she developed tetraplegia. An urgent MRI cervical spine revealed a pre-vertebral, vertebral, and epidural abscess. This was treated with an emergency C4-C7 posterior cervical laminectomy and decompression. Her inpatient care involved a protracted ICU admission followed by rehabilitation. She remains tetraplegic and requires continued inpatient care over a year after presentation. Restricted pandemic-related hospital visiting has compounded the impact of her illness.


Conclusion: Infective complications of adjuvant breast cancer chemotherapy remain an issue despite advances in supportive care. This case highlights the devastating, life-altering impact that these complications can have as emphasized by the inclusion of the patient’s perspective.

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Authors

Aoife Broderick
aoifebroderick81@gmail.com (Primary Contact)
Hailey Kathryn Carroll
Kenneth O'Riordan
Arthur Jackson
John Macfarlane
Seamus O'Reilly
1.
Broderick A, Carroll HK, O’Riordan K, Jackson A, Macfarlane J, O’Reilly S. Breeching “The Goldilocks Zone”: Tetraplegia as a Rare Life-Altering Infective Complication of Adjuvant Breast Cancer Chemotherapy: Breeching “The Goldilocks Zone”. Arch Breast Cancer [Internet]. 2022 Nov. 25 [cited 2024 Jul. 14];10(1):93-8. Available from: https://www.archbreastcancer.com/index.php/abc/article/view/631

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