Blood transfusions and survival after surgery for breast cancer.

Numerous reports have demonstrated that blood transfusions given prior to renal allografting have an immunomodulating effect that leads to increased graft survival. To determine if blood transfusions would adversely affect the outcome for patients with breast cancer, we examined 226 patients with invasive breast cancer who had a mastectomy and found 65 (29%) had received transfusions. The patients who had transfusions and those who did not were similar in age, clinical tumor-node-metastasis stage, and number of histologic nodal metastases. At a median follow-up of 52 months for surviving patients, 48 (21%) of the patients were dead. Log-rank and Cox regression analyses that compared patients who had transfusions v those who did not showed no excess of either overall deaths or deaths due to cancer in the group that received transfusions. The hypothesis that blood transfusions might have an adverse effect on survival was not supported by this study. Additional studies involving other groups of patients with malignant neoplasms and other blood donor populations are needed.