Mapping the clinical topography and progression of venous thromboembolism in Chinese breast cancer surgical patients: a prospective longitudinal study.

BACKGROUND

Venous thromboembolism (VTE) is a serious complication in breast cancer patients. However, limited attention has been given to its clinical characteristics and progression, particularly in Asian populations. Therefore, this study aimed to comprehensively investigate the clinical topography and progression of VTE in breast cancer patients using ultrasound in China.

METHODS

This prospective study was conducted at a 4500-bed tertiary hospital from August 2021 to September 2022. VTE was assessed routinely before discharge and upon self-reported symptoms. Patients without VTE during hospitalization were followed up at the 1, 3, and 6 months post-operation. Patients with VTE received weekly ultrasounds to monitor their progression. Data on clinical features, progression, and VTE-related healthcare burden were collected.

RESULTS

The cumulative incidence of VTE within six months was 19.96%, comprising lower-extremity superficial vein thrombosis (LE-SVT), lower-extremity deep vein thrombosis (LE-DVT), central venous catheter-related thrombosis (CRT), upper-extremity vein thrombosis, and pulmonary embolism (PE). VTE occurred as early as the first postoperative day, with 88.8% of cases developing during hospitalization, primarily LE-SVT and LE-DVT. CRT became predominant one month post-surgery. Early common symptoms included pain or tenderness along the puncture site, fullness pain/cramping pain/aching pain during activity. By the end of follow-up, most thrombi resolved, with minimal progression. VTE led to an additional 236 outpatient/emergency visits, three hospitalizations, and ¥148,211 costs.

CONCLUSION

VTE incidence in breast cancer patients was high post-surgery, with distinct patterns of occurrence and progression. Early symptoms were often mild, nonspecific, and transient. While most thrombi resolve, VTE imposes a heavy medical burden and requires medical attention.