Incidence and Risk Factors for Venous Thromboembolism in Female Patients Undergoing Breast Surgery

CANCERS(2022)

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摘要
Simple Summary Despite the known multiple correlations between venous thromboembolism (VTE) and breast cancer, only a limited number of studies have investigated the association between breast cancer and VTE during the long-term follow-up. Given the constantly increasing number of newly diagnosed breast cancers, the significance of focusing research on the correlation between breast cancer and VTE is becoming increasingly relevant. Furthermore, VTE has a high impact on a patient's quality of life, with permanent consequences or mortality in the most severe cases. Thus, this study aims to assess the occurrence and timing of VTE during a long period of follow-up to analyze possible correlated factors and the overall survival. These results could impact the health care community, adding knowledge about VTE risk factors. These factors can be helpful as prognostic information and eventually target preventive treatment for VTE because the co-existence of invasive breast cancer VTE has a substantial impact on survival. Albeit it does not have the highest venous thromboembolism (VTE) incidence compared to other neoplasms, breast cancer contributes to many VTE events because it is the most diagnosed tumor in women. We aim to analyze the occurrence and timing of VTE during the follow-up of patients who underwent breast surgery, the possible correlated factors, and the overall survival. This retrospective study included all female patients diagnosed with mammary pathology and surgically treated in our clinic between January 2002 and January 2012. Of 5039 women who underwent breast surgery, 1056 were found to have no evidence of malignancy, whereas 3983 were diagnosed with breast cancer. VTE rate resulted significantly higher in patients with invasive breast cancer than in women with benign breast disease or carcinoma in situ. Invasive cancers other than lobular or ductal were associated with a higher VTE rate. In addition, chronic hypertension, high BMI, cancer type, and evidence of metastasis turned out to be the most significant risk factors for VTE in women who underwent breast surgery. Moreover, VTE occurrence significantly impacted survival in invasive breast cancer patients. Compared to women with benign mammary pathology, VTE prevalence in women with breast cancer is significantly higher. The knowledge about the risk factors of VTE could be helpful as prognostic information, but also to eventually target preventive treatment strategies for VTE, as far as the co-existence of invasive breast cancer and VTE has a significantly negative impact on survival.
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关键词
breast cancer, venous thromboembolism, deep venous thrombosis, pulmonary embolism, basal-like subtype, comedo-like necrosis
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