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A Model to Estimate the Risk of Breast Cancer-Related Lymphedema: Combinations of Treatment-Related Factors of the Number of Dissected Axillary Nodes, Adjuvant Chemotherapy, and Radiation Therapy

Abstract

Purpose: The development of breast cancer-related lymphedema (LE) is closely related to the number of dissected axillary lymph nodes (N-ALNs), chemotherapy, and radiation therapy. In this study, we attempted to estimate the risk of LE based on combinations of these treatment-related factors. Methods and Materials: A total of 772 patients with breast cancer, who underwent primary surgery with axillary lymph node dissection from 2004 to 2009, were retrospectively analyzed. Adjuvant chemotherapy (ACT) was performed in 677 patients (88%). Among patients who received radiation therapy (n=675), 274 (35%) received supraclavicular radiation therapy (SCRT). Results: At a median follow-up of 5.1 years (range, 3.0-8.3 years), 127 patients had developed LE. The overall 5-year cumulative incidence of LE was 17%. Among the 127 affected patients, LE occurred within 2 years after surgery in 97 (76%) and within 3 years in 115 (91%) patients. Multivariate analysis showed that N-ALN (hazard ratio [HR], 2.81; P<.001), ACT (HR, 4.14; P=.048), and SCRT (HR, 3.24; P<.001) were independent risk factors for LE. The total number of risk factors correlated well with the incidence of LE. Patients with no risk or 1 risk factor showed a significantly lower 5-year probability of LE (3%) than patients with 2 (19%)  More>>
Authors:
Kim, Myungsoo; Kim, Seok Won; Lee, Sung Uk; Lee, Nam Kwon; Jung, So-Youn; Kim, Tae Hyun; Lee, Eun Sook; Kang, Han-Sung; [1]  Shin, Kyung Hwan, E-mail: shin.kyunghwan@gmail.com [1] 
  1. Research Institute and Hospital, National Cancer Center, Goyang (Korea, Republic of)
Publication Date:
Jul 01, 2013
Product Type:
Journal Article
Resource Relation:
Journal Name: International Journal of Radiation Oncology, Biology and Physics; Journal Volume: 86; Journal Issue: 3; Other Information: Copyright (c) 2013 Elsevier Science B.V., Amsterdam, The Netherlands, All rights reserved.; Country of input: International Atomic Energy Agency (IAEA)
Subject:
62 RADIOLOGY AND NUCLEAR MEDICINE; CHEMOTHERAPY; HEALTH HAZARDS; LYMPH NODES; MAMMARY GLANDS; MULTIVARIATE ANALYSIS; NEOPLASMS; RADIOTHERAPY; SURGERY
OSTI ID:
22224502
Country of Origin:
United States
Language:
English
Other Identifying Numbers:
Journal ID: ISSN 0360-3016; CODEN: IOBPD3; Other: PII: S0360-3016(13)00200-9; TRN: US14R1128045457
Availability:
Available from http://dx.doi.org/10.1016/j.ijrobp.2013.02.018
Submitting Site:
USN
Size:
page(s) 498-503
Announcement Date:
May 01, 2014

Citation Formats

Kim, Myungsoo, Kim, Seok Won, Lee, Sung Uk, Lee, Nam Kwon, Jung, So-Youn, Kim, Tae Hyun, Lee, Eun Sook, Kang, Han-Sung, and Shin, Kyung Hwan, E-mail: shin.kyunghwan@gmail.com. A Model to Estimate the Risk of Breast Cancer-Related Lymphedema: Combinations of Treatment-Related Factors of the Number of Dissected Axillary Nodes, Adjuvant Chemotherapy, and Radiation Therapy. United States: N. p., 2013. Web. doi:10.1016/J.IJROBP.2013.02.018.
Kim, Myungsoo, Kim, Seok Won, Lee, Sung Uk, Lee, Nam Kwon, Jung, So-Youn, Kim, Tae Hyun, Lee, Eun Sook, Kang, Han-Sung, &amp; Shin, Kyung Hwan, E-mail: shin.kyunghwan@gmail.com. A Model to Estimate the Risk of Breast Cancer-Related Lymphedema: Combinations of Treatment-Related Factors of the Number of Dissected Axillary Nodes, Adjuvant Chemotherapy, and Radiation Therapy. United States. https://doi.org/10.1016/J.IJROBP.2013.02.018
Kim, Myungsoo, Kim, Seok Won, Lee, Sung Uk, Lee, Nam Kwon, Jung, So-Youn, Kim, Tae Hyun, Lee, Eun Sook, Kang, Han-Sung, and Shin, Kyung Hwan, E-mail: shin.kyunghwan@gmail.com. 2013. "A Model to Estimate the Risk of Breast Cancer-Related Lymphedema: Combinations of Treatment-Related Factors of the Number of Dissected Axillary Nodes, Adjuvant Chemotherapy, and Radiation Therapy." United States. https://doi.org/10.1016/J.IJROBP.2013.02.018.
@misc{etde_22224502,
title = {A Model to Estimate the Risk of Breast Cancer-Related Lymphedema: Combinations of Treatment-Related Factors of the Number of Dissected Axillary Nodes, Adjuvant Chemotherapy, and Radiation Therapy}
author = {Kim, Myungsoo, Kim, Seok Won, Lee, Sung Uk, Lee, Nam Kwon, Jung, So-Youn, Kim, Tae Hyun, Lee, Eun Sook, Kang, Han-Sung, and Shin, Kyung Hwan, E-mail: shin.kyunghwan@gmail.com}
abstractNote = {Purpose: The development of breast cancer-related lymphedema (LE) is closely related to the number of dissected axillary lymph nodes (N-ALNs), chemotherapy, and radiation therapy. In this study, we attempted to estimate the risk of LE based on combinations of these treatment-related factors. Methods and Materials: A total of 772 patients with breast cancer, who underwent primary surgery with axillary lymph node dissection from 2004 to 2009, were retrospectively analyzed. Adjuvant chemotherapy (ACT) was performed in 677 patients (88%). Among patients who received radiation therapy (n=675), 274 (35%) received supraclavicular radiation therapy (SCRT). Results: At a median follow-up of 5.1 years (range, 3.0-8.3 years), 127 patients had developed LE. The overall 5-year cumulative incidence of LE was 17%. Among the 127 affected patients, LE occurred within 2 years after surgery in 97 (76%) and within 3 years in 115 (91%) patients. Multivariate analysis showed that N-ALN (hazard ratio [HR], 2.81; P<.001), ACT (HR, 4.14; P=.048), and SCRT (HR, 3.24; P<.001) were independent risk factors for LE. The total number of risk factors correlated well with the incidence of LE. Patients with no risk or 1 risk factor showed a significantly lower 5-year probability of LE (3%) than patients with 2 (19%) or 3 risk factors (38%) (P<.001). Conclusions: The risk factors associated with LE were N-ALN, ACT, and SCRT. A simple model using combinations of these factors may help clinicians predict the risk of LE.}
doi = {10.1016/J.IJROBP.2013.02.018}
journal = []
issue = {3}
volume = {86}
journal type = {AC}
place = {United States}
year = {2013}
month = {Jul}
}