Coagulation profiles of breast cancer patients attending at cancer treatment centres in Northwest Ethiopia 2023: a comparative cross-sectional study

Abstract

Breast cancer is the primary cause of cancer-related deaths in women, especially in developing nations where early detection and comorbidity management are challenging. Coagulopathy significantly enhance the disease severity, but its impact on Ethiopian patients is unclear. Therefore, this study aims to investigate and compare coagulation profiles in chemotherapy-experienced, chemotherapy-naive breast cancer patients, and healthy controls. An Institutional-based comparative cross-sectional study was conducted at the University of Gondar and Felege Hiwot Comprehensive Specialized Hospitals from 15 May 2023 to 30 August 2023 on a total of 180 participants. Participants socio-demographic and clinical data were collected using structured questionnaires in face-to-face interviews and medical record reviews. Blood sample for laboratory tests were taken, with 3 ml in ethylenediaminetetraacetic acid, 3 ml in trisodium citrate, and 2 ml in serum separator tubes. Coagulation parameters were measured using Genrui coagulation analyser (CA51) and Sysmex KX-21 hematology analyser. Data entry was done using Epi Data version 4.6 and transform to SPSS version 25 for analysis then descriptive statistics was presenting with tables. One-way ANOVA and Kruskal-Wallis tests were used to compare coagulation parameters among the three study groups, considering normal and skewed data, respectively. The activated partial thromboplastin time in chemotherapy-experienced, chemotherapy-naïve patients, and healthy controls showed median ± IQR values of 34.3 ± 15.8, 35 ± 13.3, and 29.2 ± 5.9 s, respectively, indicating a significant difference (p: 0.016). Similarly, the prothrombin time in the same groups had median ± IQR values of 15 ± 3.9, 15.3 ± 2.9, and 13.2 ± 1.9 s, respectively, with a significant difference (p < 0.001). Platelet count mean ± SD in chemotherapy-experienced, chemotherapy-naïve patients, and healthy controls were 351.3 ± 99.6, 345.6 ± 117.5, and 284.3 ± 79.3, respectively, showing a significant difference (p < 0.001). The mean ± SD of mean platelet volume in the same groups were 10.4 ± 2.7, 9.5 ± 2.4, and 9 ± 1.2, respectively, with a significant difference (p: 0.003). Coagulation parameters of both chemotherapy-experienced and chemotherapy-naïve patients were abnormally prolonged compared to healthy controls. This event indicates in vivo coagulation and it may increase bleeding tendency in patients. Therefore, early laboratory investigation of the coagulation profiles of breast cancer patients is critical for early detection and intervention of the coagulopathy.