Key result
Intermittent pneumatic compression and graduated compression effectively reduce venous thromboembolism without the haemorrhagic complications associated with heparin in breast cancer surgery.
Why the study?
What is the optimal strategy for venous thromboembolism prophylaxis in patients undergoing surgery for breast cancer?
What is the optimal strategy for venous thromboembolism prophylaxis in patients undergoing surgery for breast cancer?
In the absence of randomized trials, the authors recommend intermittent pneumatic compression and graduated compression for all breast cancer surgery patients, reserving heparin for those at very high risk.
Answers are grounded in this paper and cite their sources.
Mechanical prophylaxis may be considered for VTE prevention in breast cancer surgery; leaves open confirmation by randomized trials.
BACKGROUND: No randomized trial has yet studied venous thromboembolism (VTE) prophylaxis in patients undergoing surgery for breast cancer. METHODS: Relevant articles were identified using Medline searches. Secondary articles were identified from the reference lists of key papers. RESULTS AND CONCLUSION: The absence of randomized trials comparing different methods of VTE prophylaxis with controls makes an evidence-based consensus among breast cancer surgeons difficult. Intermittent pneumatic compression (IPC) and graduated compression (GC) are effective in reducing VTE without the haemorrhagic complications associated with heparin; their effects are additive. The authors suggest the following strategy. All patients undergoing surgery for breast cancer should receive both IPC and GC, with heparin reserved for those at very high risk. A controlled trial should randomize women to receive heparin or not, and all women should have both IPC and GC. The primary endpoints should be the development of VTE and/or haemorrhagic complications.
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Patiar et al. (2007) conducted a review in Breast cancer. Venous thromboembolism prophylaxis (intermittent pneumatic compression, graduated compression, heparin) was evaluated. Intermittent pneumatic compression and graduated compression effectively reduce venous thromboembolism without the haemorrhagic complications associated with heparin in breast cancer surgery.
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