Cancer is a recognized risk of thromboembolic events (TEE) with rates in this population up to four times higher than in the general population [1,2]. In fact, up to 30% of TEEs occur in cancer patients [3-5]. These events, in addition to concomitant morbidity and mortality, contribute to an additional economic burden on the healthcare system with hospital management costs estimated at approximately $20,000 per patient [6,7]. TEEs are believed to be the second leading cause of death in cancer patients [8] and patients with TEEs in general have worse outcomes with a 2-fold increase in the rate of death within 2 years of diagnosis in breast cancer patients [9] . The spectrum of TEE described in cancer includes, but is not limited to, venous thromboembolism (VTE), arterial thrombosis, nonbacterial thrombocytic endocarditis, and disseminated intravascular coagulopathy (DIC)[10,11]. VTE; including deep vein thrombosis (DVT) and pulmonary embolism (PE) represent the majority of TEEs [12] and are therefore the most commonly commented on. In addition to the risk factors for TEE described in the general medical population, a number of factors unique to the cancer patient have been identified as contributing to the hypercoagulable profile. [13]These have been grouped into cancer-related, patient-related and treatment-related factors [14]. Compared to cancer involving other organs such as the brain, lungs and pancreas; breast cancer is considered to be at low risk for VTE [15]. However, given the prevalence of breast cancer in the population, it is not surprising that this patient cohort contributes significantly to new cases of VTE in the cancer population, particularly in the context of advanced disease and chemotherapy [16]. We intend to highlight the role of chemotherapy... at the center of the article... for VTE in breast cancer patients. Conclusions and future perspectives Important progress continues to be made in uncovering the pathobiology and risk factors for thromboembolic events in cancer. These advances are providing evidence that supports individualizing the management of venous thromboembolism in breast cancer patients receiving chemotherapy based on risk factors. Although breast cancer is considered to be at low risk for VTE, integrating risk assessment models into the outpatient setting can help identify a cohort of patients who would benefit from prophylactic therapy and those who are at increased risk for VTE recurrence. TEV. The role of TSOACs in the management of VTE in cancer needs to be further defined. Given the central role of tissue factor in the pathogenesis of VTE in cancer, targeting this protein seems logical in the search for the perfect anticoagulant.