Application of Patient Blood Management in the Oncology Patient Affected by Breast Cancer

Preoperative anemia treatment is fundamental in Patient Blood Management (PBM) programs, a multidisciplinary and multimodal strategy that improves clinical outcomes based on the patient's blood resource, promoting strategies to optimize hematopoiesis in candidates for elective surgery, in order to significantly reduce the use of blood products, addressing all modifiable transfusion risk factors before it is even necessary to consider the use of transfusion therapy itself. Treatment with intravenous iron reduces the transfusion risk and consequently the adverse events related to the transfusion itself.

Nothing is specified in this regard for cancer patients; very often these patients come to surgery presenting an anaemic state that often requires correction with red blood cell transfusion. The aim of this clinical study is to prevent the number of perioperative transfusions in patients with breast cancer who have undergone or not undergone neoadjuvant chemotherapy and with Hb values lower than or equal to 11 g/dl, who are candidates for destructive and/or reconstructive surgery.

Inclusion criteria

• age > 18 years;
• patients diagnosed with histologically confirmed breast cancer and whether or not they have undergone neoadjuvant chemotherapy;
• patients who are candidates for destructive and reconstructive breast surgery or not;
• Hb values less than or equal to 11 g/dL and/or transferrin saturation less than or equal to 20%;
• written informed consent.

Exclusion criteria

• patients with known allergies to ferric carboxymaltose or its excipients;
• ferritin values greater than 500 ng/ml;
• patients unable to sign consent and comply with procedures.