# Ramsay-Hunt Syndrome in Patients Undergoing Dose-Dense Chemotherapy in the Perioperative Period of Breast Cancer: Two Case Reports

## TL;DR

This paper presents two rare cases of Ramsay-Hunt syndrome in breast cancer patients undergoing dose-dense chemotherapy, highlighting a potential side effect of this treatment strategy.

## Contribution

The novelty lies in reporting two rare cases linking Ramsay-Hunt syndrome with lymphopenia during dose-dense chemotherapy.

## Key findings

- Two breast cancer patients developed Ramsay-Hunt syndrome during ddAC-ddPTX therapy.
- Lymphopenia, a known side effect of the treatment, was associated with the syndrome in these cases.

## Abstract

Dose-dense doxorubicin and cyclophosphamide followed by dose-dense paclitaxel (ddAC-ddPTX therapy) is a treatment strategy that shortens intervals between chemotherapy cycles and has demonstrated efficacy in improving disease-free survival (DFS) and overall survival (OS). Moreover, this strategy is recommended by the National Comprehensive Cancer Network (NCCN) guidelines. However, adverse events, such as lymphopenia, which can lead to opportunistic infections such as pneumocystis pneumonia, have been reported, thus necessitating appropriate countermeasures. Herein, we report two rare cases of Ramsay-Hunt syndrome associated with lymphopenia during ddAC-ddPTX therapy.