Chew et al identified risk factors for venous thromboembolism in women with breast cancer. These can help identify patients who may benefit from closer monitoring and prophylaxis. The authors are from the University of California at Davis and the VA Northern California Health Care System in Sacramento.


Patient selection: women with breast cancer


Risk factors for venous thromboembolism within 2 years of cancer diagnosis (Table 2):

(1) age >= 65 years

(2) 1 or more significant comorbid conditions (hazard ratio 1.9 for 1, 2.3 for 2 and 2.9 for 3; based upon the list of comorbid conditions in Elixhauser et al, except with 5 conditions excluded)

(3) extent of disease (hazard ratio for distant metastases 6; for regional lymph nodes 2)


Protective factors:

(1) Asian ancestry


Modifications: I added previous history of hypercoagulable state as a separate risk factor in the implementation.


The highest incidence for venous thromboembolism is during the first 6 months after diagnosis.


The development of venous thromboembolism during the first 2 years is associated an increased risk of death within 2 years of breast cancer diagnosis (hazard ratio 2.3).


To read more or access our algorithms and calculators, please log in or register.