The Effect of whole-Blood Transfusion on Survival of Patients with Breast Cancer: Why the Controversies?

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Abstract
Disputes still arise about the adverse effect of perioperative transfusion on survival of patients with malignant solid tumors. In order to find some answers to these controversies the author has studied 880 new patients with operable breast cancer, among whom 486 (55.2%) had received perioperative transfusion. In 86% of the patients the tumor size, when known, measured 3.0 cm (T2) or less. In general the ten-year actuarial survival of the 486 transfused patients has been 59.9% versus 66.7% for 394 nontransfused ones, X2 = 4.47; d.o.f. = 1, P <0.05. In multivariate analysis it was noted that only positive nodes had affected the survival significantly (P = 10-9) and blood group had produced a trend (P = 0.08). However, when the period cohort was eliminated, the adverse effect of transfusion became evident in patients with blood group A in the 1968-69 and 1970-71 cohorts but not in those with blood group O. It is concluded that the combined effect of transfusion and blood group, as a risk factor, is not as strong as positive nodes and large size of tumor. This study confirms that transfusion effect, at surgery, is a blood-group-related phenomenon.