Osteonecrosis of the femoral head following adjuvant chemotherapy for breast cancer

We report a case of osteonecrosis in a patient treated with adjuvant chemot herapy for breast cancer. A 68-year-old woman presented with severe right h ip pain. Seven months after completing a course of 6 cycles of adjuvant Cyc lophosphamide, Methotrexate and 5-Fluorouracil with standard anti-emetic pr ophylaxis of Dexamethasone and Domperidone for a T2N0M0 breast cancer. Inve stigations revealed evidence of osteonecrosis of the right femoral head. Du e to ongoing hip pain, she underwent an elective total hip replacement and her mobility has returned almost to normal. Osteonecrosis has been associat ed with corticosteroids and cytotoxic regimens which omit these agents. Ost eonecrosis is a rare complication, of cytotoxic therapy but with the increa sing use of chemotherapy it should be considered in the differential diagno sis of joint pain in patients who have received antitumour therapies. (C) 2 001 Harcourt Publishers Ltd.