Low-dose aspirin for the prevention of venous thromboembolism in breast cancer patients treated with infusional chemotherapy after insertion of central vein catheter.
BACKGROUND
We previously demonstrated a high incidence (7.7%) of venous thromboembolism (VTE) in breast cancer patients treated with infusional chemotherapy after insertion of central vein catheters (CVC). The aim of this study was to evaluate the efficacy and safety of low-dose aspirin for the prevention of VTE.


METHODS
In a monocentric prospective study, patients with stage II-IV breast cancer, who underwent CVC insertion for continuous infusional chemotherapy, were assigned to receive low-dose aspirin (100 mg daily). Treatment was started after CVC implantation and continued until the last day of chemotherapy. Patients were assessed for safety and for the incidence of symptomatic deep venous thrombosis (DVT) confirmed by color-Doppler ultrasonography.


RESULTS
Between April 2000 and March 2004, 188 consecutive patients were included in the study. Median age was 48 years (range 22-83), 31 patients (16%) had concomitant hypertension, and 14 patients (7.4%) were smokers. Median duration of treatment with aspirin was 3.6 months (range 0.4-5.7). A DVT confirmed by color-Doppler ultrasonography was observed in four patients (2.1%; 95% confidence interval, 0.58-5.35%). Side effects included mild epistaxis (three patients, 1.5%) and mild gastric pain (two patients, 1%). No major bleeding complication or International Normal Ratio alteration occurred.


CONCLUSIONS
Administration of low-dose aspirin is safe and seems to correlate with a low risk of DVT in breast cancer patients treated with infusional chemotherapy. Further randomized studies comparing low-dose aspirin with other anticoagulative agents are warranted.
Curigliano
Giuseppe
G
Division of Medical Oncology, Department of Medicine, European Institute of Oncology, Via Ripamonti 435, 20141 Milan, Italy.
Balduzzi
Alessandra
A
Cardillo
Anna
A
Ghisini
Raffaella
R
Peruzzotti
Giulia
G
Orlando
Laura
L
Torrisi
Rosalba
R
Dellapasqua
Silvia
S
Lunghi
Loredana
L
Goldhirsch
Aron
A
Colleoni
Marco
M
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000008:administration & dosage* / Q000627:therapeutic use; D001241:Aspirin / Q000008:administration & dosage* / Q000627:therapeutic use; D001943:Breast Neoplasms / Q000145:classification / Q000150:complications / Q000188:drug therapy*; D002405:Catheterization, Central Venous; D005260:Female; D006801:Humans; D007262:Infusions, Intravenous; D007558:Italy; D008875:Middle Aged; D011446:Prospective Studies; D054556:Venous Thromboembolism / Q000517:prevention & control*
D000894:Anti-Inflammatory Agents, Non-Steroidal; D001241:Aspirin