Time‐dependent risk and predictors of venous thromboembolism in breast cancer patients: A population‐based cohort study

Abstract

This study confirms the long-term risk of VTE in breast cancer patients and identifies a comprehensive set of clinical risk predictors. Temporal associations with patient, tumor, and treatment characteristics provide insight into the time-dependent etiology of VTE. Cancer 2017;123:468-475. © 2016 American Cancer Society.

Deep vein thrombosis incidence in women diagnosed with breast cancer in brazil between 2007-2009

“…Regarding radiotherapy, in multiple analysis, women in this study who underwent such treatment had no risk of developing DVT. In the Swedish population-based study that included 8,338 breast cancer patients, the radiotherapy showed no association with VTE in multivariable analyses (HR=1.07, 95% CI 0.79-1.47) [16] Begtrupo et al in a prospective clinical study evaluated blood sampling in 39 women who underwent adjuvant radiotherapy after breast cancer in the year 2016 at a Danish center and concluded that radiotherapy did not affect hemostasis evaluated by platelet aggregation and thrombin generation; neither as a single dose nor during the entire radiation course [26].…”

“…[20] Similarly, in our study, age was risk factor in multiple analyses and chemotherapy was the main risk factor for DVT. Although chemotherapy treatment is associated with an increased risk of thrombosis [11,16,20], the pathogenic mechanisms for the thrombogenic effect of chemotherapeutic drugs are poorly understood [21]. Probably, chemotherapeutic agents are associated with thrombogenic mechanisms, such as reduction in fibrinolytic activity, direct endothelial cells lesions and interaction with the Von Willebrand factor [22].…”

“…However, in the study by Brand et al, hormonal therapy use was not statistically significant associated with a higher risk of developing VTE (HR=1.60, 95% CI 0.87-2.94, adjusted for age at diagnosis). Moreover, Brand et al observed that the negative status for progesterone hormone receptors was an independent risk factor for the development of VTE in women with breast cancer (HR=1.38, 95% CI 1.12-1.70, adjusted for age at diagnosis) but negative status for estrogen hormone receptors had no effect [16]. In contrast, in cohort of Chavez-MacGregor et al, with men and women breast cancers, negative status for estrogen hormone receptors was a protect factor for VTE (OR=0.84, 95% CI 0.73-0.96) and for DVT (OR=0.72, 95% CI 0.59 -0.88) in multiple analyses [11].…”

The Saudi clinical practice guideline for the prophylaxis of venous thromboembolism in long-distance travelers

“…Firstly, we agree that hormonal therapy for breast cancer therapy is a risk factor for VTE,6 and that individuals on such therapy are high-risk travelers. Hence, the guideline applies to them as it applies to individuals with any other risk factor for VTE.…”

A specific controlled ovarian stimulation (COS) protocol for fertility preservation in women with breast cancer undergoing neoadjuvant chemotherapy

“…It is possible that their different mechanisms of action would be complementary, with the aromatase inhibitor decreasing the estrogen level and thus allowing tamoxifen to function more effectively as a competitive inhibitor with estradiol. In order to mitigate thromboembolic event, which is a serious complication of cancer [ 13 ] and which can be exacerbated by the use of tamoxifen [ 14 ], we proposed the prophylactic use of a low molecular weight heparin, enoxaparin, administered on a daily basis, throughout ovarian stimulation.…”