Hemostasis disorders during neoadjuvant therapy in patients with breast cancer

Impaired hemostasis in breast cancer (BC) has an extremely negative impact on the life expectancy of patients, including due to the high risk of tumor progression. Objective. Identification of predictors of hemostasis disorders in patients with BC during neoadjuvant drug therapy (neoDT). Material and methods. The study included 31 patients with primary BC. The investigation of hemostasis was carried out 3 weeks after the completion of the first cycle neoDT and included spatial thrombodynamic (sTD) data, the results of counting neutrophil extracellular traps (NETs) and analysis of the level of inflammatory markers. Results. During the NLT period, hypercoagulation (HC), hyperfibrinogenemia, or high platelet-lymphocyte index were detected in 42, 39, and 68% of patients with breast cancer. Patients with HC were significantly more likely to have low differentiation (G3) of the tumor and high NETs levels (p=0.048 and p=0.017, respectively). In addition, an association was found between the detection of HC and such parameters of BC malignancy as young age (p=0.055) and high index of proliferative activity Ki67 (p=0.063). Conclusion. The development of HC is observed in a large number of BC patients during neoDT. An increase in the level of NETs may be in such patients an element of the pathogenesis of homeostasis disorders, as well as one of the predictors of the malignant course of BC.