"Lymphedema causes physical discomfort and disability, as well as a cosmetic deformity which can lead to anxiety, depression and emotional distress that can affect a woman's activities of daily living and quality of life," says lead author Tina Yen, M.D., M.S., a Medical College of Wisconsin surgical oncologist who practices at Froedtert Hospital, a major hospital affiliate.
"For these reasons, lymphedema is probably the most feared complication among breast cancer survivors. A better understanding of its risk factors is needed to help improve outcomes."
The study appears online, in advance of publication in the April issue of Annals of Surgical Oncology. It is significant because there are few large, population-based studies on this topic looking at long-term outcomes from more than one institution, and much of the existing literature was written 20-30 years ago, when more extensive surgeries to the breast and armpit (axilla) were performed and use of radiation therapy to the armpit was more common.
The researchers conducted three phone surveys between 2005 and 2007 among 1,338 community-dwelling women, ages 65-89 years, who were identified by Medicare claims as having undergone initial breast cancer surgery in 2003. These 1,338 women were treated by 707 surgeons. Four years after surgery, 14 percent self-reported having lymphedema.
Women who developed lymphedema were more likely to have more extensive disease, have undergone more extensive surgery and received chemotherapy. However, after controlling for a woman's age, tumor size, type of surgery, other therapies and surgeon volume, the removal of more than five lymph nodes and the presence of cancer in the lymph nodes were the only two factors that predicted a risk for lymphedema. Most importantly, the number of lymph nodes removed is more predictive of the risk for lymphedema rather than the type of axillary surgery performed (sentinel lymph node biopsy versus axillary node dissection).
If no lymph nodes were removed, the risk for lymphedema was 4.7 percent. Removal of up to five lymph nodes did not increase the risk of lymphedema, when compared to the removal of no lymph nodes. However, the removal of between six and 15 lymph nodes increased that risk five-fold, and removal of 16 or more lymph nodes increased the risk of developing lymphedema by more than ten-fold. Given these findings, all women undergoing any axillary surgery should still be counseled on their risk for lymphedema, although this risk may be minimal for women who have fewer than five lymph nodes removed.
The study was supported by grants from the National Institutes of Health's National Cancer Institute.
Toranj Marphetia | EurekAlert!
Do microplastics harbour additional risks by colonization with harmful bacteria?
05.04.2018 | Leibniz-Institut für Ostseeforschung Warnemünde
Rutgers-led innovation could spur faster, cheaper, nano-based manufacturing
14.02.2018 | Rutgers University
University of Connecticut researchers have created a biodegradable composite made of silk fibers that can be used to repair broken load-bearing bones without the complications sometimes presented by other materials.
Repairing major load-bearing bones such as those in the leg can be a long and uncomfortable process.
Study published in the journal ACS Applied Materials & Interfaces is the outcome of an international effort that included teams from Dresden and Berlin in Germany, and the US.
Scientists at the Helmholtz-Zentrum Dresden-Rossendorf (HZDR) together with colleagues from the Helmholtz-Zentrum Berlin (HZB) and the University of Virginia...
Novel highly efficient and brilliant gamma-ray source: Based on model calculations, physicists of the Max PIanck Institute for Nuclear Physics in Heidelberg propose a novel method for an efficient high-brilliance gamma-ray source. A giant collimated gamma-ray pulse is generated from the interaction of a dense ultra-relativistic electron beam with a thin solid conductor. Energetic gamma-rays are copiously produced as the electron beam splits into filaments while propagating across the conductor. The resulting gamma-ray energy and flux enable novel experiments in nuclear and fundamental physics.
The typical wavelength of light interacting with an object of the microcosm scales with the size of this object. For atoms, this ranges from visible light to...
Stable joint cartilage can be produced from adult stem cells originating from bone marrow. This is made possible by inducing specific molecular processes occurring during embryonic cartilage formation, as researchers from the University and University Hospital of Basel report in the scientific journal PNAS.
Certain mesenchymal stem/stromal cells from the bone marrow of adults are considered extremely promising for skeletal tissue regeneration. These adult stem...
In the fight against cancer, scientists are developing new drugs to hit tumor cells at so far unused weak points. Such a “sore spot” is the protein complex...
13.04.2018 | Event News
12.04.2018 | Event News
09.04.2018 | Event News
20.04.2018 | Physics and Astronomy
20.04.2018 | Interdisciplinary Research
20.04.2018 | Physics and Astronomy