Thrombotic complications and thromboprophylaxis in breast and gynaecological malignancies.
OBJECTIVE
Thrombotic complications are a common cause of morbidity and mortality in patients with gynaecological or advanced breast malignancies. There are several manifestations of thromboembolism in these patients, but deep venous thrombosis of the legs is the usual presentation. This review highlights various manifestations of thrombotic complications in these malignancies, and also describes the current evidence base for various forms of thromboprophylaxis.


RESULTS
Several trials have suggested that low molecular weight heparin therapy is at least as effective as oral anticoagulation for secondary prophylaxis. It has also been suggested that low molecular weight heparin therapy may prolong survival in cancer patients, but this was not shown in the results of one recently published placebo-controlled randomized trial.


CONCLUSIONS
Primary thromboprophylaxis in cancer should be individualized and considered according to the risk category of each patient. Low molecular weight heparin therapy can be used for secondary thromboprophylaxis in patients with breast or gynaecological malignancy. However, more studies are needed to substantiate their acceptance in cancer patients.
Goyal
Deepak
D
Haemostasis Thrombosis and Vascular Biology Unit, University Department of Medicine, City Hospital, Birmingham B18 7QH, UK.
Choudhury
Anirban
A
Lip
Gregory Y H
GY
D000284:Administration, Oral; D000925:Anticoagulants / Q000627:therapeutic use*; D001943:Breast Neoplasms / Q000150:complications*; D005260:Female; D005833:Genital Neoplasms, Female / Q000150:complications*; D006495:Heparin, Low-Molecular-Weight / Q000627:therapeutic use*; D006801:Humans; D016032:Randomized Controlled Trials as Topic; D012307:Risk Factors; D013923:Thromboembolism / Q000209:etiology / Q000517:prevention & control; D013927:Thrombosis / Q000209:etiology* / Q000517:prevention & control*
D000925:Anticoagulants; D006495:Heparin, Low-Molecular-Weight