To analyze the impact of different clinical characteristics and endocrine drugs on blood coagulation in breast cancer patients.

The clinical data and pathological features of 209 female patients with breast invasive ductal carcinoma treated at the First Affiliated Hospital of Guangzhou Medical University from 2016 to 2020 were retrospectively analyzed. Associations between clinicopathological features and coagulation parameters were evaluated, with longitudinal assessment of coagulation changes before and after endocrine therapy.

Among the 209 patients with invasive ductal carcinoma of the breast prior to treatment, the levels of fibrinogen (FIB) and thrombin time (TT) were higher in patients older than 55 years compared to those 55 years or younger. Additionally, postmenopausal patients exhibited higher levels of FIB and TT than non-menopausal patients. However, there was no significant difference in coagulation indicators between the lymph node metastasis group and the non-metastatic group (P>0.05). In patients with tumor node metastasis classification (TNM) stage Ⅲ-Ⅳ breast cancer, levels of prothrombin time, international normalized ratio, TT, and PLT were higher than those in stage Ⅰ-Ⅱ patients. Conversely, prothrombin time test activity levels were lower (P<0.05). There was no significant difference in various coagulation indicators, PLT value, and red cell distribution width-coefficient of variation (RDW-CV) between different expression intensities of estrogen receptor, progestin recetor, human epidermal growth factorreceptor 2, and Ki-67 (P>0.05). After endocrine therapy, RDW-CV levels were lower in patients treated with aromatase inhibitor (AI) compared to pre-therapy levels (P<0.05). The levels of activated partial thromboplastin time (APTT), RDW-CV and PLT in patients treated with tamoxifen (TAM) were lower while TT was higher than those in pre-therapy (P<0.05). The levels of APTT and RDW-CV in patients treated with toremifene (TOR) were lower than those in pre-therapy (P<0.05). The TT of patients receiving combination therapy was higher, while the PLT level was lower than that in pre-therapy (P<0.05).

Advanced age, menopause and higher TNM stage are risk factors for hypercoagulability in patients with invasive ductal carcinoma of the breast. TAM and TOR exert procoagulant effects, and the combination therapy has a tendency to promote coagulation, while AI minimally affects coagulation. Monitoring the coagulation indicators is essential for selecting treatment options and optimizing care for patients with invasive ductal carcinoma of the breast.