Efficacy and Safety of Dose-dense Chemotherapy in Breast Cancer: Real Clinical Data and Literature Review

Dose-dense (dd) chemotherapy shortens the interval between chemotherapy cycles and has shown improved outcomes in high-risk breast cancer patients. We retrospectively evaluated the efficacy and safety of dd chemotherapy in 80 breast cancer patients treated at our hospital from 2020 to 2024. The regimen included epirubicin and cyclophosphamide followed by paclitaxel or docetaxel, with pegfilgrastim support. The overall treatment completion rate was 82.5%. Among 55 neoadjuvant cases, the pathologic complete response (pCR) rate was significantly higher in triple-negative breast cancer (TNBC) (59.1%) compared to luminal type (9.1%). Common adverse events included anemia, liver dysfunction, myalgia, and peripheral neuropathy. Febrile neutropenia occurred in 8.8% of patients, with some cases linked to pegfilgrastim body pod use, particularly in individuals with low subcutaneous fat. Notably, two patients developed pneumocystis pneumonia, potentially associated with steroid administration. Despite these toxicities, most were manageable and resolved after treatment. Our findings support the efficacy of dd chemotherapy, particularly in TNBC, while highlighting the importance of individualized supportive care and vigilance regarding hematologic and infectious complications.