The use of white blood cell growth stimulating factor drugs to reduce risk of infection in women with breast cancer receiving common first-cycle chemotherapies only reduced hospitalization by 6 percent or less, according to a study published in the Journal of Clinical Oncology. The study also confirmed that fever and infections among these women were very low even without the use of growth factor. The study of medications that help white blood cell growth , also known as granulocyte colony-stimulating factor or G-CSF, was authored by representatives from HealthCore, Inc., Anthem, Inc. and the American Society of Clinical Oncology. The authors of study are Abiy Agiro, Qinli Ma, Anupama Kurup Acheson, Sze-jung Wu, Debra A. Patt, John J. Barron, Jennifer L. Malin, Alan Rosenberg, Richard L. Schilsky, and Gary H. Lyman. Through the Choosing Wisely® campaign, ASCO issued guidance advising oncologists not to use white cell stimulating factor for prevention of neutropenia for patients with less than a 20 percent risk of getting an infection. The three regimens studied have been considered low-to-moderate risk for inducing neutropenia-related complications as less than 20 percent of patients being treated with these chemotherapies experience febrile neutropenia. "In women with breast cancer treated with a conventional dose of doxorubicin and cyclophosphamide, a chemotherapy regimen that has low risk of infection, more than half of them were also treated with G-CSF, with no benefit," said Abiy Agiro, lead author and research manager for HealthCore. "This is unfortunate, especially given that patients can experience uncomfortable side effects from G-CSF, such as bone pain, headache and nausea. When the chemotherapy risk for neutropenia is low, these high-cost agents place an unnecessary burden on the healthcare system without providing a discernable benefit to the patient." The retrospective analysis included patients with breast cancer who began first-cycle chemotherapy from 2008 to 2013 using docetaxel and cyclophosphamide, also known as TC or carboplatin, docetaxel and trastuzumab, also known as TCH or doxorubicin, and cyclophosphamide, also known as conventional dose AC.