Forum for Science, Industry and Business

Sponsored by:     3M 
Search our Site:

 

Breast Cancer Patients’ Fear of Developing Lymphedema Far Exceeds Risk

26.02.2013
New Journal of the American College of Surgeons study reveals trends in patient worry and risk-reducing behaviors in women undergoing breast cancer treatment

Women who have had the lymph nodes under their arm surgically removed during breast cancer treatment are warned to avoid certain practices that can cause lymphedema—a condition that causes chronic, painless swelling in the arm.

Now, a new study published in the March issue of the Journal of the American College of Surgeons suggests that the vast majority of women who undergo breast cancer operations worry about developing this complication and that this fear far exceeds their actual risk of getting lymphedema. In fact, most women adopt four to five commonly recommended measures to prevent this incurable condition despite little data supporting the efficacy of these precautionary behaviors.

During breast cancer treatment, women are advised to take certain preventive steps to reduce their chance of developing lymphedema. These preventive measures include vigilant skin care to avoid injury (avoidance of needle punctures or blood draws), not getting one’s blood pressure taken in the affected arm, frequent use of compression garments, and various other practices. The truth is that clinicians don’t really know if any of these precautionary measures change the outcomes for these women.

“Clinicians don’t really know what causes lymphedema, and there is an overall lack of data supporting or refuting these risk-reducing practices,” said lead study author Sarah McLaughlin, MD, FACS, assistant professor of surgery at the Mayo Clinic in Jacksonville, FL. “And because women worry about that disfiguring process, they adopt practices that are basically grounded in myth, not fact.”

About 90 percent of women who will develop lymphedema do so within three years of breast cancer treatment. It occurs in about 20 percent of women who undergo axillary lymph node dissection (ALND)—a procedure in which 10–20 lymph nodes (on average) in the armpit are removed and checked for cancer cells. It also develops in about 5 percent of women who undergo sentinel lymph node biopsy (SLNB)—a less extensive procedure in which only a few lymph nodes closest to the breast are taken out and analyzed.

To document the lymphedema rate, patient worry, and risk-reduction behaviors in women undergoing breast cancer surgery, researchers at the Mayo Clinic in Florida followed 120 women, ages 52-68, for 12 months. Of those women, 53 underwent ALND and 67 had SLNB. The same two clinicians saw all patients postoperatively at one-, six-, and 12-month intervals. During these visits, the women completed questionnaires about their lymphedema risk-reduction behaviors, and assessments of their fear and worry about developing the condition.

Researchers found that 75 percent of women who had ALND, and 52 percent of women who had SLNB, worried about getting lymphedema. While lymph node removal can increase the chance of developing this complication, the study results showed that only 19 percent of those who had ALND actually developed lymphedema, and only 3 percent of those who underwent SLNB got it. The study also showed that at 12 months, the extent of axillary surgery (the number of nodes taken out in the armpit) was the only significant risk for developing lymphedema. Age, weight, type of breast operation (breast-conserving or mastectomy), or radiation were not linked to an increase in lymphedema.

What’s more, researchers found that the majority of women adopted as many as five precautionary behaviors as early as six months after breast cancer operations and maintained these behaviors long term despite their actual risk—meaning they undertook these measures regardless of whether they had undergone ALND or SLNB and their course of treatment (radiation and adjuvant chemotherapy).

The investigators say that future research should be aimed at better predicting which women will develop lymphedema, thus allowing for targeted prevention and intervention strategies and individualized plans for risk-reducing behaviors for each woman during and after her breast cancer treatment.

“This is the first step to quantify the problem. The aim is to educate not just patients but providers about what we really need to do, which is to better stratify patients in terms of what their true risk really is,” Dr. McLaughlin said. “The goal is to be able to tell the average woman, ‘Listen, your risk is low so you don’t need to do these other things, and you can go about your life and be active and not worry to such a great extent that you are going to suffer this complication.’ The goal is to alleviate much of the anxiety that women carry,” Dr. McLaughlin said.

Other study participants include Sanjay Bagaria, MD; Tammeza Gibson, PA-C; Michelle Arnold, BS; Nancy Diehl, BS; Julia Crook, PhD; Alexander Parker, PhD; and Justin Hung Nguyen, MD, FACS, all from Mayo Clinic in Florida.

Funding for this research was provided by a Bankhead Coley Florida Cancer Research Program.

Citation: Journal of the American College of Surgeons, March 2013: Vol 216(3): 380-386.


About the American College of Surgeons
The American College of Surgeons is a scientific and educational organization of surgeons that was founded in 1913 to raise the standards of surgical practice and improve the quality of care for all surgical patients. The College is dedicated to the ethical and competent practice of surgery. Its achievements have significantly influenced the course of scientific surgery in America and have established it as an important advocate for all surgical patients. The College has more than 79,000 members and is the largest organization of surgeons in the world. For more information, visit www.facs.org.

Sally Garneski | EurekAlert!
Further information:
http://www.facs.org

More articles from Studies and Analyses:

nachricht Multi-year study finds 'hotspots' of ammonia over world's major agricultural areas
17.03.2017 | University of Maryland

nachricht Diabetes Drug May Improve Bone Fat-induced Defects of Fracture Healing
17.03.2017 | Deutsches Institut für Ernährungsforschung Potsdam-Rehbrücke

All articles from Studies and Analyses >>>

The most recent press releases about innovation >>>

Die letzten 5 Focus-News des innovations-reports im Überblick:

Im Focus: Giant Magnetic Fields in the Universe

Astronomers from Bonn and Tautenburg in Thuringia (Germany) used the 100-m radio telescope at Effelsberg to observe several galaxy clusters. At the edges of these large accumulations of dark matter, stellar systems (galaxies), hot gas, and charged particles, they found magnetic fields that are exceptionally ordered over distances of many million light years. This makes them the most extended magnetic fields in the universe known so far.

The results will be published on March 22 in the journal „Astronomy & Astrophysics“.

Galaxy clusters are the largest gravitationally bound structures in the universe. With a typical extent of about 10 million light years, i.e. 100 times the...

Im Focus: Tracing down linear ubiquitination

Researchers at the Goethe University Frankfurt, together with partners from the University of Tübingen in Germany and Queen Mary University as well as Francis Crick Institute from London (UK) have developed a novel technology to decipher the secret ubiquitin code.

Ubiquitin is a small protein that can be linked to other cellular proteins, thereby controlling and modulating their functions. The attachment occurs in many...

Im Focus: Perovskite edges can be tuned for optoelectronic performance

Layered 2D material improves efficiency for solar cells and LEDs

In the eternal search for next generation high-efficiency solar cells and LEDs, scientists at Los Alamos National Laboratory and their partners are creating...

Im Focus: Polymer-coated silicon nanosheets as alternative to graphene: A perfect team for nanoelectronics

Silicon nanosheets are thin, two-dimensional layers with exceptional optoelectronic properties very similar to those of graphene. Albeit, the nanosheets are less stable. Now researchers at the Technical University of Munich (TUM) have, for the first time ever, produced a composite material combining silicon nanosheets and a polymer that is both UV-resistant and easy to process. This brings the scientists a significant step closer to industrial applications like flexible displays and photosensors.

Silicon nanosheets are thin, two-dimensional layers with exceptional optoelectronic properties very similar to those of graphene. Albeit, the nanosheets are...

Im Focus: Researchers Imitate Molecular Crowding in Cells

Enzymes behave differently in a test tube compared with the molecular scrum of a living cell. Chemists from the University of Basel have now been able to simulate these confined natural conditions in artificial vesicles for the first time. As reported in the academic journal Small, the results are offering better insight into the development of nanoreactors and artificial organelles.

Enzymes behave differently in a test tube compared with the molecular scrum of a living cell. Chemists from the University of Basel have now been able to...

All Focus news of the innovation-report >>>

Anzeige

Anzeige

Event News

International Land Use Symposium ILUS 2017: Call for Abstracts and Registration open

20.03.2017 | Event News

CONNECT 2017: International congress on connective tissue

14.03.2017 | Event News

ICTM Conference: Turbine Construction between Big Data and Additive Manufacturing

07.03.2017 | Event News

 
Latest News

Pulverizing electronic waste is green, clean -- and cold

22.03.2017 | Materials Sciences

Astronomers hazard a ride in a 'drifting carousel' to understand pulsating stars

22.03.2017 | Physics and Astronomy

New gel-like coating beefs up the performance of lithium-sulfur batteries

22.03.2017 | Materials Sciences

VideoLinks
B2B-VideoLinks
More VideoLinks >>>