Risk factors for postoperative bleeding following breast cancer surgery: a systematic review and meta-analysis.

OBJECTIVE

Surgical operation serves as a primary approach for addressing cancer of the breast, but it also has potential complications, including hemorrhaging following surgery. Identifying the risk variables associated with this problem may assist individuals in stratifying and optimizing their risks. A meta-analysis and comprehensive review was conducted to pinpoint the risk variables associated with postoperative hemorrhaging in breast carcinoma.

METHODS

We performed a systematic review and searched through Cochrane Library, PubMed, WoS, Embase, China National Knowledge Infrastructure, and Wanfang. The investigation spanned from the creation of the records until May 2025. A meta-analysis was performed to investigate the risk variables associated with postoperative hemorrhaging in breast carcinoma patients.

RESULTS

8 studies were included, comprising 82,012 patients. A total of 10 risk factors were analyzed. They are mastectomy and axillary lymph node dissection, antithrombotic medication, age ≥ 60 years old, hypertension, and diabetes, chronic pulmonary illness, congestive heart failure, reconstruction and neoadjuvant chemotherapy. These results indicated that among the multiple risk factors included in the analysis, 3 had statistically significant effects on postoperative bleeding following breast cancer surgery: specifically, mastectomy (OR = 1.93,95%CI:1.20-3.09), hypertension(OR = 1.23,95%CI:1.05-1.44), CHF(OR = 2.18,95%CI:1.54-3.08).

CONCLUSION

Breast cancer risk factors for postoperative hemorrhage include mastectomy, hypertension and CHF. Understanding the risk factors closely related to postoperative bleeding in breast cancer is helpful for identifying high-risk patients with postoperative bleeding, who can benefit from enhanced prevention and treatment. In the future, more and larger sample size studies are needed to continue to investigate additional indicators of risk for hemorrhaging following surgery in breast carcinoma.