Assessment of genetic predisposition to lymphedema.

2011 ◽  
Vol 29 (27_suppl) ◽  
pp. 195-195
Author(s):  
J. M. Armer ◽  
B. R. Stewart

195 Background: In the United States, 203,000 women are diagnosed annually with breast cancer (BC). Currently, over 2.3 million women in the United States are breast cancer survivors. With the increased incidence and survivorship, more women are living with the long-term treatment effects such as lymphedema (LE). We are nearing completion of stage one of a three-stage research project to examine genetic factors that potentially predispose BC survivors to develop LE. In stage one, we are working to identify novel genetic polymorphisms pointing to genomic regions and genes associated with LE risk. In stage two, we will use exome sequencing to examine both rare and common genetic variants potentially associated with variation in symptom manifestations of LE in breast cancer survivors; to examine phenotypic and genotypic variation in LE emerging following cancer treatment; and to examine associations between LE phenotypes among breast cancer survivors with LE and genomic factors and non-genomic factors. In stage three, we will replicate at the genetic level the associations detected. Methods: Institutional funding was obtained for a GWAS-design feasibility study with 96 breast cancer survivors with and without LE (48/48). Genetic material (from buccal swabs), limb volume (by perometry and circumferences), and self-reported LE-related symptoms were collected in one laboratory appointment. Results: Ninety-five percent of survivors participating in an on-going longitudinal study consented to participate in the genetic pilot (N=96). Buccal swabs provided yield for DNA extraction (concentration average 174.94 ng/ul). An additional 96 specimens have been collected for a second pilot GWAS (N =192). Conclusions: The pilot findings form the basis for a larger multisite proposed study to examine genetic predisposition to secondary LE. The findings of the larger study will lead to the design and timing of subsequent interventions aimed at reducing LE risk and improving overall survivorship quality of life. Findings concerning interactions among best cancer treatments and LE genetic predisposition will have the potential to guide the selection of cancer treatment to minimize complications when survival outcomes are equivalent across competing treatment approaches.

2008 ◽  
Vol 26 (5) ◽  
pp. 759-767 ◽  
Author(s):  
Patricia A. Ganz ◽  
Erin E. Hahn

Breast cancer survivors account for 23% of the more than 10 million cancer survivors in the United States today. The treatments for breast cancer are complex and extend over a long period of time. The post-treatment period is characterized by gradual recovery from many adverse effects from treatment; however, many symptoms and problems persist as late effects (eg, infertility, menopausal symptoms, fatigue), and there may be less frequent long-term effects (eg, second cancers, lymphedema, osteoporosis). There is increasing recognition of the need to summarize the patient's course of treatment into a formal document, called the cancer treatment summary, that also includes recommendations for subsequent cancer surveillance, management of late effects, and strategies for health promotion. This article provides guidance on how oncologists can implement a cancer treatment summary and survivorship care plan for breast cancer survivors, with examples and linkage to useful resources. Providing the breast cancer treatment summary and survivorship care plan is being recognized as a key component of coordination of care that will foster the delivery of high-quality cancer care.


2006 ◽  
Vol 30 (1) ◽  
pp. 52-57 ◽  
Author(s):  
Christine M. Duffy ◽  
Melissa A. Clark ◽  
Jenifer E. Allsworth

Cancer ◽  
2009 ◽  
Vol 115 (9) ◽  
pp. 1954-1966 ◽  
Author(s):  
Roberta De Angelis ◽  
Andrea Tavilla ◽  
Arduino Verdecchia ◽  
Steve Scoppa ◽  
Mark Hachey ◽  
...  

2019 ◽  
Vol 43 (4) ◽  
pp. E207-E216
Author(s):  
Grace A. Kanzawa-Lee ◽  
Robert Knoerl ◽  
David A. Williams ◽  
Daniel J. Clauw ◽  
Celia M. Bridges ◽  
...  

2018 ◽  
Vol 14 (4) ◽  
pp. 205-211 ◽  
Author(s):  
Bonnie Ky

Breast cancer is the most common malignancy in women with more than 3 million breast cancer survivors in the United States alone. Survivors of breast cancer suffer from an increased burden of cardiovascular risk factors and disease. The focus of this review is to describe the epidemiology of cardiovascular disease in breast cancer survivors, including the cardiovascular concerns observed with common cancer therapies. Strategies to improve upon the early detection and treatment of cardiovascular disease, including clinical prediction algorithms, biomarkers, and imaging measures are also reviewed, and the use of cardioprotective therapies to mitigate risk are summarized. Finally, the need for evidence-based research to inform and improve upon the multidisciplinary care of this growing population is highlighted.


2007 ◽  
Vol 25 (21) ◽  
pp. 3001-3006 ◽  
Author(s):  
Timothy L. Lash ◽  
Matthew P. Fox ◽  
Diana S.M. Buist ◽  
Feifei Wei ◽  
Terry S. Field ◽  
...  

Purpose There are more than 2,000,000 breast cancer survivors in the United States today. While surveillance for asymptomatic recurrence and second primary is included in consensus recommendations, the effectiveness of this surveillance has not been well characterized. Our purpose is to estimate the effectiveness of surveillance mammography in a cohort of breast cancer survivors with complete ascertainment of surveillance mammograms and negligible losses to follow-up. Patients and Methods We enrolled 1,846 stage I and II breast cancer patients who were at least 65 years old at six integrated health care delivery systems. We used medical record review and existing databases to ascertain patient, tumor, and therapy characteristics, as well as receipt of surveillance mammograms. We linked personal identifiers to the National Death Index to ascertain date and cause of death. We matched four controls to each breast cancer decedent to estimate the association between receipt of surveillance mammogram and breast cancer mortality. Results One hundred seventy-eight women died of breast cancer during 5 years of follow-up. Each additional surveillance mammogram was associated with a 0.69-fold decrease in the odds of breast cancer mortality (95% CI, 0.52 to 0.92). The protective association was strongest among women with stage I disease, those who received mastectomy, and those in the oldest age group. Conclusion Given existing recommendations for post-therapy surveillance, trials to compare surveillance with no surveillance are unlikely. This large observational study provides support for the recommendations, suggesting that receipt of surveillance mammograms reduces the rate of breast cancer mortality in older patients diagnosed with early-stage disease.


2017 ◽  
Vol 35 (2) ◽  
pp. 149-156 ◽  
Author(s):  
Catherine M. Alfano ◽  
Juan Peng ◽  
Rebecca R. Andridge ◽  
Monica E. Lindgren ◽  
Stephen P. Povoski ◽  
...  

Purpose The sequelae of cancer treatment may increase systemic inflammation and create a phenotype at increased risk of functional decline and comorbidities, leading to premature mortality. Little is known about how this trajectory compares with natural aging among peers of the same age without cancer. This longitudinal study investigated proinflammatory cytokines and comorbidity development over time among breast cancer survivors and a noncancer control group. Methods Women (N = 315; 209 with breast cancer and 106 in the control group) were recruited at the time of their work-up for breast cancer; they completed the baseline questionnaire, interview, and blood draw (lipopolysaccharide-stimulated production of interleukin [IL] -6, tumor necrosis factor-α, and IL-1β). Measures were repeated 6 and 18 months after primary cancer treatment (cancer survivors) or within a comparable time frame (control group). Results There were no baseline differences in comorbidities or cytokines between survivors and the control group. Over time, breast cancer survivors had significantly higher tumor necrosis factor-α and IL-6 compared with the control group. Survivors treated with surgery, radiation, and chemotherapy accumulated a significantly greater burden of comorbid conditions and suffered greater pain associated with inflammation over time after cancer treatment than did the control group. Conclusion Survivors who had multimodal treatment had higher cytokines and comorbidities, suggestive of accelerated aging. Comorbidities were related to inflammation in this sample, which could increase the likelihood of premature mortality. Given that many comorbidities take years to develop, future research with extended follow-up beyond 18 months is necessary to examine the evidence of accelerated aging in cancer survivors and to determine the responsible mechanisms.


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