Breast Cancer-Related Lymphedema: a Review of Risk Factors, Radiation Therapy Contribution, and Management Strategies

2020 ◽  
Vol 12 (4) ◽  
pp. 305-316
Author(s):  
Tracy M. Nassif ◽  
Cheryl L. Brunelle ◽  
Tessa C. Gillespie ◽  
Madison C. Bernstein ◽  
Loryn K. Bucci ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Risk Factors ◽  
Radiation Therapy ◽  
Management Strategies ◽  
Breast Cancer Related Lymphedema

scholarly journals Assessment of Potential Risk Factors and Skin Ultrasound Presentation Associated with Breast Cancer-Related Lymphedema in Long-Term Breast Cancer Survivors

Diagnostics ◽  
2021 ◽  
Vol 11 (8) ◽  
pp. 1303
Author(s):  
Khairunnisa’ Md Yusof ◽  
Kelly A. Avery-Kiejda ◽  
Shafinah Ahmad Suhaimi ◽  
Najwa Ahmad Zamri ◽  
Muhammad Ehsan Fitri Rusli ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Risk Factors ◽  
Cancer Survivors ◽  
Potential Risk ◽  
Breast Cancer Survivors ◽  
Ultrasound Examination ◽  
Arm Circumference ◽  
Potential Risk Factors ◽  
Breast Cancer Related Lymphedema

Breast cancer has been reported to have the highest survival rate among various cancers. However, breast cancer survivors face several challenges following breast cancer treatment including breast cancer-related lymphedema (BCRL), sexual dysfunction, and psychological distress. This study aimed to investigate the potential risk factors of BCRL in long term breast cancer survivors. A total of 160 female breast cancer subjects were recruited on a voluntary basis and arm lymphedema was assessed through self-reporting of diagnosis, arm circumference measurement, and ultrasound examination. A total of 33/160 or 20.5% of the women developed BCRL with significantly higher scores for upper extremity disability (37.14 ± 18.90 vs. 20.08 ± 15.29, p < 0.001) and a lower score for quality of life (103.91 ± 21.80 vs. 115.49 ± 16.80, p = 0.009) as compared to non-lymphedema cases. Univariate analysis revealed that multiple surgeries (OR = 5.70, 95% CI: 1.21–26.8, p < 0.001), axillary lymph nodes excision (>10) (OR = 2.83, 95% CI: 0.94–8.11, p = 0.047), being overweight (≥25 kg/m2) (OR = 2.57, 95% CI: 1.04 – 6.38, p = 0.036), received fewer post-surgery rehabilitation treatment (OR = 2.37, 95% CI: 1.05–5.39, p = 0.036) and hypertension (OR = 2.38, 95% CI: 1.01–5.62, p = 0.043) were associated with an increased risk of BCRL. Meanwhile, multivariate analysis showed that multiple surgeries remained significant and elevated the likelihood of BCRL (OR = 5.83, 95% CI: 1.14–29.78, p = 0.034). Arm swelling was more prominent in the forearm area demonstrated by the highest difference of arm circumference measurement when compared to the upper arm (2.07 ± 2.48 vs. 1.34 ± 1.91 cm, p < 0.001). The total of skinfold thickness of the affected forearm was also significantly higher than the unaffected arms (p < 0.05) as evidenced by the ultrasound examination. The continuous search for risk factors in specific populations may facilitate the development of a standardized method to reduce the occurrence of BCRL and provide better management for breast cancer patients.

scholarly journals Systemic Analysis on Risk Factors for Breast Cancer Related Lymphedema

2014 ◽  
Vol 15 (16) ◽  
pp. 6535-6541 ◽  
Author(s):  
Ya-Qun Zhu ◽  
Yu-Huan Xie ◽  
Feng-Huan Liu ◽  
Qi Guo ◽  
Pei-Pei Shen ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Risk Factors ◽  
Systemic Analysis ◽  
Breast Cancer Related Lymphedema

scholarly journals Radiation Therapy Risk Factors for Development of Lymphedema in Patients Treated With Regional Lymph Node Irradiation for Breast Cancer

2015 ◽  
Vol 91 (4) ◽  
pp. 760-764 ◽  
Author(s):  
Ravi A. Chandra ◽  
Cynthia L. Miller ◽  
Melissa N. Skolny ◽  
Laura E.G. Warren ◽  
Nora Horick ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Risk Factors ◽  
Radiation Therapy ◽  
Lymph Node ◽  
Regional Lymph Node ◽  
Lymph Node Irradiation

Risk factors for breast cancer-related lymphedema: correlation with docetaxel administration

Breast Cancer ◽  
2020 ◽  
Vol 27 (5) ◽  
pp. 929-937 ◽  
Author(s):  
Yuka Aoishi ◽  
Shoji Oura ◽  
Haruka Nishiguchi ◽  
Yoshimitsu Hirai ◽  
Miwako Miyasaka ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Risk Factors ◽  
Breast Cancer Related Lymphedema

Does radiation therapy increase late cardiac death in patients with left breast cancer?

2013 ◽  
Vol 31 (15_suppl) ◽  
pp. 1127-1127
Author(s):  
Chi Lin ◽  
Kyle A. Denniston ◽  
Mary E. Charlton
Keyword(s):  
Breast Cancer ◽  
Risk Factors ◽  
Logistic Regression ◽  
Radiation Therapy ◽  
Cardiac Death ◽  
Lower Risk ◽  
Logistic Regression Model ◽  
Left Breast ◽  
Multivariate Logistic Regression Model ◽  
Multivariate Logistic Regression

1127 Background: The objective of this study was to evaluate the effect of external beam radiation therapy (RT) on late cardiac death (CD) in patients with left breast cancer. Methods: A total of 529,246 patients who were diagnosed with adenocarcinoma of the breast between 1983 and 2004 and survived ≥ 5 years were identified from the SEER database. After excluding patients who were male, had right breast cancer, received brachytherapy or had missing data, 163,894 patients remained. Examined risk factors for CD include age (≤49/50-59/60-69/70-100), race (white/non-white), stage (In situ/local/regional/distant), breast subsite (nipple and areola/inner quadrant/outer quadrant), diagnosis year (1983-1993/1994-2004), surgery status (none/less than mastectomy/mastectomy) and RT. Time to CD was evaluated using the Kaplan-Meier method. A multivariate logistic regression model was used to evaluate factors associated with the use of RT and the Cox Proportional Hazards model was used to evaluate risk factors for CD. Results: A multivariate logistic regression model revealed that patients who received RT tended to be younger, white, more recently diagnosed, have inner quadrant and more advanced disease and undergo less than mastectomy. Median overall survival for patients with RT was significantly longer than those without RT (263 vs. 226 months, Log-Rank p < .0001). RT group had a lower risk of CD than no-RT group (Log-Rank p < .0001). Median time to CD was not reached in either group. The probability of CD was increased with increasing age and stage, and decreased with more recent diagnosis year and after mastectomy. Cox model found RT to be associated with lower probability of CD (HR 0.66, 95% CI 0.62-0.70), after adjusting for age, stage, surgery status and diagnosis year. Race and breast subsite were not associated with CD. Conclusions: Patients with left breast cancer who survived ≥ 5 years and received RT had a lower risk of cardiac death than those who did not. The cause of this difference is unclear but suggests influence from an uninvestigated factor, potentially the increased use of cardiotoxic chemotherapy or other cardiovascular comorbidity in those patients not receiving RT. Continued study, accounting for such factors, is warranted.

scholarly journals Erratum to: Radiation therapy targets and the risk of breast cancer-related lymphedema: a systematic review and network meta-analysis

2017 ◽  
Vol 162 (2) ◽  
pp. 217-217
Author(s):  
Simona F. Shaitelman ◽  
Yi-Ju Chiang ◽  
Kate D. Griffin ◽  
Sarah M. De Snyder ◽  
Benjamin D. Smith ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Systematic Review ◽  
Radiation Therapy ◽  
Meta Analysis ◽  
Therapy Targets ◽  
Breast Cancer Related Lymphedema

scholarly journals Atherosclerosis of brachiocephalic arteries and arterial stiffness in patients with breast cancer

Kardiologiia ◽  
2019 ◽  
Vol 59 (1S) ◽  
pp. 43-52 ◽  
Author(s):  
A. Yu. Filatova ◽  
M. V. Vitsenya ◽  
A. V. Potekhina ◽  
S. V. Gavryushina ◽  
E. A. Pylaeva ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Risk Factors ◽  
Blood Pressure ◽  
Radiation Therapy ◽  
T Lymphocytes ◽  
Vascular Wall ◽  
Anticancer Therapy ◽  
Atherosclerosis Progression ◽  
Healthy Women ◽  
Brachiocephalic Arteries

Cardiovascular toxicity is one of the important problems of clinical oncology. Atherosclerosis progression was demonstrated in patients with cancer and chemotherapy.Te aim– to evaluate the vascular wall characteristics and to determine the predictors of AS of brachiocephalic arteries progression during anticancer therapy in patients with breast cancer.Methods.Te study involved 43 patients with newly diagnosed breast cancer (BC) (II–III stage) with overexpression of HER2; median age 50 (40;57) years. All patients underwent neoadjuvant drug therapy with antracyclines, taxanes and trastuzumab followed by surgery, radiation and hormone therapy according to the indications. Before anticancer therapy the general clinical examination was conducted and lipid profle, plasma lipoprotein (a) [Lp(a)] level, titres of autoantibodies IgM and IgG to lipoproteins and their oxidized derivatives were estimated. Te vascular wall stiffness (pulse wave velocity on the carotid-femoral (PWVcf) and shoulder-ankle (PWVsa) segments, the central pressure, carotid intima-media thickness (CIMT) and the degree of stenosis of the brachiocephalic arteries) were determined at baseline and at each stage of anticancer therapy. Te atherosclerosis progression was determined if the new stenosis (≥15%) or increase of preexisting stenosis (≥5%) were revealed; CIMT increase ≥ 0.1 mm. Te parameters of cellular immunity (peripheral blood lymphocyte phenotyping via direct immunofluorescence and flow cytometry), lipid spectrum parameters, serum concentration of Lp (a), autoantibodies IgM and IgG against lipoproteins and their oxidized derivatives, as well as PWVсf and PWVsa were assessed in 17 BC patients before the onset of neoadjuvant therapy and in 20 healthy women.Results.BC patients and healthy women were comparable in traditional cardiovascular risk factors but differed in PWVsa and PWVcf levels (p<0.05). In BC patients the activation of T-cell immunity with the stimulation of both subpopulations with pro-inflammatory and regulatory properties was observed (p<0.05). Te direct correlations between the content of activated T-lymphocytes (T-act), T-helpers (T) 1 and PWVsa (p<0.05), as well as T-act, T1 and T2 and PWVcf (p<0.05) were revealed in the general group. Te decrease of systolic blood pressure (SBP), central SBP (SBPc), central diastolic blood pressure (DBPc), PWVcf and PWVsa levels accompanied with a temporary heart rate increase were observed during anticancer therapy; SBP, SBPc, PWVcf levels restored by the end of the follow-up period. Te CIMT increase was detected in 22 (51%), and the atherosclerosis progression in 26 (60%) BC patients during anticancer therapy. Lp (a) level above 12.8 mg/dl was associated with CIMT increase (p<0.05). Age > 48 years and radiation therapy were risk factors for CIMT increase and atherosclerosis progression (p<0.05), respectively.Conclusions. Te vascular stiffness is increased in BC patients, which is associated with the activation of effector subpopulations of T-lymphocytes and the elevation of circulating level of both pro-atherogenic and anti-atherogenic T-cells. Te level of Lp (a) above 12.8 mg/dl is associated with atherosclerosis progression, which requires further research. Age and radiation therapy are the risk factors for atherosclerosis progression during anticancer therapy.

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