title: Anticoagulant medication at time of needle biopsy for breast cancer in relation to risk of lymph node metastasis.
abstract: Anticoagulant treatment might enhance the natural defense against tumor cell dissemination caused by diagnostic needle biopsy by counteracting thrombocyte coating of such cells. To clarify whether women using anticoagulant treatment at the time of biopsy have a lower occurrence of lymph node metastasis, we conducted a nationwide Swedish cohort study of 26,528 female incident breast cancer patients in 2006-2011. Point risk ratio (RR) of risk of lymph node metastasis among users of anticoagulant treatment adjusted for age, T-stage, socioeconomic factors, and concomitant medication was RR = 0.94, (95% CI: 0.87-1.03), and lower in younger women (RR = 0.80, 95% CI 0.50-1.29). Although nonsignificant, these associations may underestimate a true negative association since women using anticoagulant treatment are likely to have more concomitant diseases, lead an unhealthier lifestyle, and have lower participation in mammography screening. These findings provide some support for the hypothesis that anticoagulant medications might counteract breast cancer spread caused by needle biopsy.
authors.affiliation: Upper Gastrointestinal Surgery Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden; Unit of Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.
authors.forename: Rickard
authors.initials: R
authors.lastname: Ljung
authors.forename: Roland
authors.initials: R
authors.lastname: Sennerstam
authors.forename: Fredrik
authors.initials: F
authors.lastname: Mattsson
authors.forename: Gert
authors.initials: G
authors.lastname: Auer
authors.forename: Jesper
authors.initials: J
authors.lastname: Lagergren
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000925:Anticoagulants / Q000008:administration & dosage* / Q000009:adverse effects; D001241:Aspirin / Q000008:administration & dosage* / Q000009:adverse effects; D001707:Biopsy, Needle; D001777:Blood Coagulation / Q000187:drug effects; D001792:Blood Platelets / Q000187:drug effects / Q000473:pathology*; D001943:Breast Neoplasms / Q000150:complications / Q000175:diagnosis* / Q000473:pathology; D055088:Early Detection of Cancer; D005260:Female; D006801:Humans; D008207:Lymphatic Metastasis / Q000473:pathology / Q000517:prevention & control; D008327:Mammography; D008875:Middle Aged; D013548:Sweden; D044465:White People
chemical_list: D000925:Anticoagulants; D001241:Aspirin
keywords: Sweden; anticoagulantia; aspirin; biopsy; breast cancer; clotting; mammography; metastasis; stage