Balancing Venous Thromboembolism and Hematoma After Breast Surgery

Lovely, Jenna K.; Nehring, Sharon A.; Boughey, Judy C.; Degnim, Amy C.; Donthi, Rajakumar V.; Harmsen, William S.; Jakub, James W.

doi:10.1245/s10434-012-2524-y

Cited by 30 publications

(15 citation statements)

References 15 publications

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“…Similar data was presented by De Martino et al suggesting the presence of 0.19% of symptomatic deep vein thrombosis, pulmonary embolism 0.12% and 0.28% of VTE within 30 days after breast cancer surgery [59]. Lovely et al report about 0.5% of cases of VTE in patients undergoing surgery for breast cancer reasons [60]. The authors of the above-mentioned studies also point to potential risk factors in this population other than just cancer presence [58][59][60].…”

Section: Chapter 2 the Prevention Of Venous Thromboembolism In Cancesupporting

confidence: 73%

“…Lovely et al report about 0.5% of cases of VTE in patients undergoing surgery for breast cancer reasons [60]. The authors of the above-mentioned studies also point to potential risk factors in this population other than just cancer presence [58][59][60].…”

Section: Chapter 2 the Prevention Of Venous Thromboembolism In Cancementioning

confidence: 97%

“…Reports of VTE occurrences are followed by other cancer surgery procedures of the head and neck, which include oral and maxillofacial surgery procedures or also commonly performed breast cancer surgery [55][56][57][58][59][60]. According to Tran et al the risk of overt VTE in a population of 49 028 patients undergoing mastectomy amounted to 0.23% [58].…”

Section: Chapter 2 the Prevention Of Venous Thromboembolism In Cancementioning

confidence: 99%

See 2 more Smart Citations

Venous thromboembolism prophylaxis in cancer patients — guidelines focus on surgical patients

Urbanek¹,

Krasiński

Kostrubiec

et al. 2017

Acta Angiologica

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Section: Chapter 2 the Prevention Of Venous Thromboembolism In Cancesupporting

confidence: 73%

Section: Chapter 2 the Prevention Of Venous Thromboembolism In Cancementioning

confidence: 97%

Section: Chapter 2 the Prevention Of Venous Thromboembolism In Cancementioning

confidence: 99%

See 1 more Smart Citation

Venous thromboembolism prophylaxis in cancer patients — guidelines focus on surgical patients

Urbanek¹,

Krasiński

Kostrubiec

et al. 2017

Acta Angiologica

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“…During the following six months [7][8][9][10][11][12], fewer patients (around 18%) for cancer, leading to additional morbidity and a compromised quality of life [3]. Apart from the surgery itself, the risk for VTE is also increased by hormonal therapy, chemotherapy and the necessary placement of central venous catheters for the administration of medications [2].…”

Section: Timing Of Vte Developmentmentioning

confidence: 99%

“…It is well known and there is considerable evidence showing that mechanical and medical prophylaxis against VTE in surgical patients decreases the incidence of DVT and PE dramatically [11]. The benefit is more pronounced in high-risk patients, depending on individual characteristics, the nature of the disease, duration of surgery and the length of non-ambulation [11].…”

Section: Breast Cancer Vte and Prophylaxismentioning

confidence: 99%

Breast cancer and thromboembolism

Lanitis¹,

Kouloura²,

Karaliotas

et al. 2015

Hellenic J Surg

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Venous thromboembolism (VTE) is a common cause of morbidity and mortality. The incidence in the general population is 0.117/year. Cancer patients carry a four-fold risk, increasing the annual incidence to 0.48/year. Breast cancer is one of the most common cancers and the second leading cause of cancer among women. In this review, we intend to present how breast cancer and its treatment contribute to the development of VTE and how this affects the prognosis. We also aim to clarify whether prophylaxis is indicated, and if so, in which subgroup of patients and under which conditions. Based on the current literature, breast cancer is associated with the lowest incidence of VTE among cancers, and thus the routine use of prophylaxis is not recommended. Nevertheless, the occurrence of VTE significantly affects the prognosis. The more advanced the stage of breast cancer, the greater the risk of VTE, although VTE is more lethal when it occurs in the early stages of breast cancer (BC). The risk of VTE decreases with time after the diagnosis. However, the later it occurs, the more it will affect the prognosis. The risk for VTE should be estimated for each patient and decisions should be individualized according to the general medical condition of the patient, other predisposing risk factors, the type and duration of surgery, the adjuvant treatment used and the past medical history of VTE. After surgery, early mobilization and stockings should be used. If the duration of the operation exceeds three hours, prophylaxis ought to be given. Prophylaxis should be considered in all cases with primary reconstruction. When it comes to adjuvant therapy, it is advisable to avoid the concomitant administration of chemotherapy and hormone treatment. Moreover, if not contraindicated, aromatase inhibitor (AI) should be preferred in postmenopausal women. In high-risk patients who will receive adjuvant treatment, prophylaxis can be considered for 3-6 months. Finally, due the interactions of the medications, low molecular weight heparin (LMWH) should be preferred to warfarin.

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Venous thromboembolism chemoprophylaxis in mastectomy patients: A 5‐year follow‐up study

Melik

Nehring

et al. 2019

Journal of Surgical Oncology

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BackgroundVenous thromboembolism (VTE) chemoprophylaxis in breast surgery remains controversial. In 2012, we instituted a practice change of routine chemoprophylaxis for patients with invasive cancer undergoing mastectomy. Herein, we report the effects of this on rates of VTE and hematoma.MethodsOur 30‐day rates of VTE and hematoma requiring reoperation among patients with mastectomy since the practice change were retrospectively collected from National Surgical Quality Improvement Program (NSQIP). The subsequent 5‐year data (2012‐2017) was compared with historic NSQIP data (2006‐2010). We utilized information from our 30‐day follow‐up databank to assess patients not sampled by NSQIP.ResultsAfter the practice change, the heparin prophylaxis rate rose from 19.5% to 95.6% (P < .001) and the VTE rate fell from 0.8% to 0% (P = .30). There was no significant change in reoperative hematoma rate (P = .39). The majority of the current NSQIP patient population (93.1%) had a Caprini score of 5 or greater. Among 663 patients obtained from 30‐day postoperative follow‐up, there were 2 VTE (0.3%) and 7 (1.1%) reoperations for hematoma.ConclusionsThe practice change resulted in an increase of VTE chemoprophylaxis without significant change in hematoma incidence. Although not statistically significant, VTE incidence decreased. This supports the use of standardized VTE chemoprophylaxis in this population and warrants further study.

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Balancing Venous Thromboembolism and Hematoma After Breast Surgery

Cited by 30 publications

References 15 publications

Venous thromboembolism prophylaxis in cancer patients — guidelines focus on surgical patients

Venous thromboembolism prophylaxis in cancer patients — guidelines focus on surgical patients

Breast cancer and thromboembolism

Venous thromboembolism chemoprophylaxis in mastectomy patients: A 5‐year follow‐up study

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