Thrombophilic risk factors in breast cancer patients

Activation of the coagulation system in cancer patients is a long known but still poorly understood phenomenon. To clarify the role of some thrombophilic risk factors in cancer patients, activated protein C sensitivity ratio [APC-SR], protein C activity and antithrombin III [AT III] activity, protein S activity as well as antiphospholipid activity [IgG, IgM] were assessed in 24 women with lymph node positive breast carcinoma, 12 of them had proven distant metastases and another 12 of them had no evidence of distant metastases, in addition to 20 matched healthy control subjects. From this study, there is significant decrease in APC-SR, protein C activity, protein S activity in breast cancer patients compared to control group. Also, there is a significant decrease in the same parameters in patients with metastases compared to those without metastases. The odds ratio for risk of thrombosis associated with breast cancer patients in presence of APC resistance phenotype is 3 and 95% confidence interval [C.l.] is 0.633- 16.89. From this study, we can conclude that APC-resistant phenotype is the most frequent thrombophilic risk factor in cancer breast patients. So, screening assay of APC-SR should be encouraged in cancer breast patients especially those having distant metastases, aiming to reduce the risk of thrombosis