Bad Blood: Navigating VTE Risk in Breast, Ovarian, and Endometrial Cancer

Abstract

Simple Summary Cancer-associated thrombosis (CAT) is one of the most frequent and life-threatening complications in patients with gynecologic cancers, significantly contributing to morbidity, mortality, treatment interruptions, and increased healthcare costs. Breast, ovarian, and endometrial cancers display distinct thrombotic profiles driven by endocrine signaling, tumor biology, systemic inflammation, obesity, and anticancer treatments. In breast cancer, thrombotic risk is largely influenced by endocrine therapies, particularly tamoxifen. Ovarian cancer is among the most thrombogenic solid tumors, reflecting aggressive disease behavior, pronounced inflammatory activation, and intensive multimodal treatment approaches. Endometrial cancer is strongly linked to obesity-related inflammation, metabolic dysfunction, and perioperative thrombotic events. Understanding these sex-specific and tumor-specific mechanisms is crucial for accurate risk stratification and individualized thromboprophylaxis. With improving cancer survival, prevention of thrombotic complications is becoming an essential component of long-term oncologic care. Advances in biomarkers, molecular profiling, and artificial intelligence-based predictive tools are expected to further enhance personalized prevention strategies and improve clinical outcomes in patients with hormone-sensitive malignancies.