Venous thrombosis in breast cancer patients receiving tamoxifen and/or chemotherapy: A systematic review. L. K. Hicks, M. C. Cheung, M. Crump; University of Toronto, Toronto, ON, Canada Abstract: Background: The association between breast cancer and venous thromboembolism (VTE) is well established. It is also generally accepted that antineoplastic therapy contributes to VTE-risk. However, the contribution of specific treatments has not been precisely determined. Methods: We systematically reviewed the literature on the association between VTE and chemohormonal therapy for breast cancer. Two authors independently selected articles from the PUBMED database. Inclusion criteria were studies of (1) breast cancer patients, (2) antineoplastic therapy, (3) VTE as a primary outcome, and (4) English language. Exclusion criteria were studies with (1) a sample size of less than 20, or (2) no control group. A grading scale for article quality was developed with guidance from Levine M et al, JAMA: 271(20), 1994. Two investigators independently graded all eligible reports. Results: The search strategy yielded 460 articles. Eight articles met all inclusion and exclusion criteria. The kappa statistic for article selection revealed excellent agreement between the two abstractors (K=0.87). Three studies addressed the association of adjuvant tamoxifen with VTE, 3 addressed the association of combined tamoxifen and chemotherapy with VTE, and 2 addressed the association of chemotherapy alone with VTE. The studies were heterogeneous with respect to design and quality. Seven studies reported a positive association between tamoxifen and/or chemotherapy and VTE. No studies achieved the highest possible quality score on our scale. No studies reported that their experimental and control arms were balanced with respect to major VTE risk factors. Only 2 studies ensured that the diagnosis of VTE was objectively determined in all cases. Conclusions: Current data suggests that both chemotherapy and tamoxifen contribute to the risk of VTE in breast cancer patients. However, there are few studies investigating VTE as a primary endpoint in breast cancer treatment. Moreover, the quality of existing studies is not high. To determine how much breast cancer treatment contributes to VTE-risk additional trials with VTE as a pre-specified, primary outcome are required. Abstract No: 6145 Abstract #801 ASCO, 2004 Remember we are NOT Doctors and have NO medical training. This site is like an Encylopedia - there are many pages, many links on many topics. Support our work with any size DONATION - see left side of any page - for how to donate. You can help raise awareness of CAM.