09 August 2026
: Case report 
Invasive Breast Cancer Complicated by Colitis After TCbHP Chemotherapy: A Case Report
Unusual clinical course, Challenging differential diagnosis, Unusual or unexpected effect of treatment, Diagnostic / therapeutic accidents, Adverse events of drug therapy
Zicong You
ABCDEF 1, Yue Deng BC 2, Shiying Cao BC 1, Fei Wang ACE 1*
DOI: 10.12659/AJCR.952507
Am J Case Rep 2026; 27:e952507
Table 1 Diagnostic criteria and clinical decision-making for suspected chemotherapy-associated colitis.
| Step | Component | Key points |
|---|---|---|
| Abdominal pain, diarrhea, with or without fever and neutropenia after recent chemotherapy | ||
| Negative stool cultures, negative toxin assay findings, and exclusion of inflammatory bowel disease and cytomegalovirus infection (with tissue testing if indicated) | ||
| Computed tomography imaging (bowel wall thickening, fat stranding); colonoscopy (mucosal erythema, erosions, ulceration); biopsy (active inflammation and exclusion of chronic changes) | ||
| Temporal relationship, rechallenge (if applicable), response to drug withdrawal, and Naranjo score (interpreted cautiously in multi-agent regimens) | ||
| Grade 1–2: symptomatic treatment with or without dose reduction; Grade 3–4: withhold suspected agent and switch to an alternative regimen if feasible |