The Risk of Haematoma and Venous Thrombosis Associated With Thromboprophylaxis Use in Breast Cancer Surgery: A Meta-Analysis and Systematic Review

Abstract

Background: The routine use of venous thromboembolism (VTE) prophylaxis in breast cancer surgery has caused substantial polarity among breast cancer surgeons across the globe. The aim of this study is to assess the use of VTE prophylaxis in breast cancer surgery outcomes. Methods: A comprehensive electronic search was undertaken of all comparative studies that described the role of VTE prophylaxis in breast cancer surgery. Studies that reported on postoperative outcomes between patients who received VTE prophylaxis (prophylaxis) and those who did not (no prophylaxis) were included in the review. A meta-analysis using random-effect model was used to analyse key outcomes, with data presented as odd ratio (OR). Results: A total of 2470 patients from 6 studies were included in this study. Among these patients, 60.9% (n: 1504) received prophylaxis. The haematoma rate in this study is 0.05% (n: 133). The incidence of haematoma was significantly associated with the use of prophylaxis (6.85% versus 3.11%, p : 0.001). Surgical intervention for haematomas was also significantly associated in this group (3.15% versus 0.83%, p : 0.004). However, there was no difference in VTE events between both groups (0.26% versus 0.36%, p : 0.88). Conclusions: The use of VTE prophylaxis in breast cancer surgery is associated with increased haematomas without any benefit in preventing VTE events. Future studies that examine the use of risk assessment tools for VTE prophylaxis in high risk patients may be beneficial.