Few studies have explored this theme and evidence on the effectiveness of the methods used to control bleeding is unknown, leading to a lack of consensus to support clinical practice. Thus, this study aimed to identify and evaluate current evidence on topical hemostasis from malignant wounds caused by breast cancer and suggest new topics for future research. This review was conducted. Seven indexed databases were consulted using the terms: "breast neoplasms"; "breast cancer"; "malignant fungating wounds"; "malignant wounds"; "bleeding." From the 112 articles identified in total, six were included in this review: a descriptive cohort study (n = 32), two case series (n = 21) and three case reports (n = 3). Fifty-six patients were exposed to 11 types of topical treatments using calcium alginate, surgical hemostats, adrenaline, nonadherent dressings, silver nitrate, modified Mohs Paste, and 10% formalin. There were no reports of significant adverse effects.  Although studies have promoted positive results of topical hemostasis, scientific evidence is still weak and arises from studies with poor methodological quality. Randomized controlled trials were not identified. The results highlight the crucial need for pilot studies to evaluate effect size, study procedures, and measurable results. And more studies of the modified Mohs Paste and 10% formalina in improve the quality of health in palliative care.

Flavia Firmino has completed her PhD at the age of 46 years from the Nursing School of São Paulo University. She is the nurse department of palliative care of Cancer National Institute. She has been serving as coordenate member of the nursing committee of nursing of the National Academy of Palliative Care (ANCP) in Brazil.