Risk Factors And Prognosis Of Venous Thromboembolism In Patients With Breast Cancer

Objective:This study aimed to investigate the risk factors for VTE in breast cancer patients,then to explore the impact of VTE events on long-term prognosis in breast cancer patients.Methods:A retrospective analysis was made on the clinical data and follow-up of 63patients with breast cancer complicated with venous thromboembolism admitted to the First Breast Hospital of Jilin University from January 2011 to June 2015.From January 2011 to June 2015,2,281 patients with breast cancer who had no VTE in our department underwent 1:2 pairing with 63 patients with VTE in the experimental group according to age,pathological type,pathological stage,histological grade,and molecular typing.The clinical and pathological data of the two groups were collected to analyze the risk factors of VTE in breast cancer patients.Survival analysis was performed to explore the difference of the prognosis between the two groups.The independent factors affecting the prognosis of breast cancer patients were analyzed to seek whether VTE affects the long-term outcome of breast cancer patients without the lethal event of VTE.Results:(1)The incidence of VTE in breast cancer patients in our hospital is about2.2%,mainly in postmenopausal patients.VTE events mainly occurred in 2~4days after operation and they mainly occurred in autumn.The lower extremity venous thrombosis is more common in the left lower extremity,mostly in the intermuscular vein,followed by the iliac vein and the posterior tibial vein.(2)Body mass index(BMI)≥28,hyperlipidemia,operative time>100minutes was associated with VTE events in breast cancer patients(χ~2 test,P<0.05).(3)Kaplan-Meier analysis showed no significant difference in total survival(OS)between the thrombus group and the control group(Log-Rank test,P=0.828).Disease-free survival(DFS)was also not statistically significant(Log-Rank Test,P=0.935).(4)Cox proportional hazard model multivariate analysis showed that after exclusion of the risk of death caused by VTE events in patients,age>65 years old,molecular classification of breast cancer was an independent risk factor for breast cancer DFS(P<0.05)except VTE(P=0.828).(5)Under different molecular stratification,DFS of Luminal A breast cancer patients was adversely affected by VTE events(Log-rank test,P=0.037).Conclusion:(1)Patients with breast cancer associated with VTE have no significant effect on long-term survival of patients after excluding the possibility of a fatal risk such as PE.(2)For patients with BMI≥28,we should pay attention to the risk of VTE.We should minimize the duration of surgery,avoid the occurrence of VTE,and reduce the early fatal events of VTE.(3)VTE events may have an impact on the long-term prognosis of certain types of breast cancer patients(Luminal A breast cancer),but more data support is needed.