Time‐Course of Arm Lymphedema and Potential Risk Factors for Progression of Lymphedema After Breast Conservation Treatment for Early Stage Breast Cancer
Identifieur interne : 005782 ( Istex/Corpus ); précédent : 005781; suivant : 005783Time‐Course of Arm Lymphedema and Potential Risk Factors for Progression of Lymphedema After Breast Conservation Treatment for Early Stage Breast Cancer
Auteurs : Voichita Bar Ad ; Pinaki R. Dutta ; Lawrence J. Solin ; Wei-Ting Hwang ; Kay See Tan ; Stefan Both ; Andrea Cheville ; Eleanor E. R. HarrisSource :
- The Breast Journal [ 1075-122X ] ; 2012-05.
Abstract
Abstract: The objective of this study was to describe the progression of arm lymphedema (ALE) after the initial presentation among patients receiving breast conservation therapy for early stage breast cancer and to identify potential risk factors contributing to ALE progression. The study sample was the 266 stage I or II breast cancer patients with documented ALE who underwent breast conservation therapy that included lumpectomy, axillary staging followed by radiation therapy. ALE were graded according to a difference of 0.5–2 cm (mild), 2.1–3 cm (moderate), and >3 cm (severe) in the circumference between the upper extremities for the treated and untreated sides. ALE at presentation was scored as mild, moderate, and severe in 109 (41%), 125 (47%), and 32 (12%) patients, respectively. One third of patients with ALE progressed to a more severe grade of lymphedema at 5 years of follow‐up. Age older than 65 years at the time of breast cancer treatment was associated with higher risk of ALE progression when compared 65 year age or younger (p = 0.04). The patients who had regional lymph node irradiation including posterior axillary boost were at higher risk of lymphedema progression than the patients treated with whole breast irradiation only (p = 0.001). Progression of ALE is a common occurrence. The current study provides support for the utility of routine arm measurements after breast cancer treatment to facilitate timely diagnosis and treatment of ALE.
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DOI: 10.1111/j.1524-4741.2012.01229.x
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Solin</name><affiliation><mods:affiliation>Department of Radiation Oncology, University of Pennsylvania, Philadelphia, Pennsylvania</mods:affiliation></affiliation></author><author><name sortKey="Hwang, Wei Ing" sort="Hwang, Wei Ing" uniqKey="Hwang W" first="Wei-Ting" last="Hwang">Wei-Ting Hwang</name><affiliation><mods:affiliation>Department of Biostatistics and Epidemiology, University of Pennsylvania, Philadelphia, Pennsylvania</mods:affiliation></affiliation></author><author><name sortKey="Tan, Kay See" sort="Tan, Kay See" uniqKey="Tan K" first="Kay See" last="Tan">Kay See Tan</name><affiliation><mods:affiliation>Department of Biostatistics and Epidemiology, University of Pennsylvania, Philadelphia, Pennsylvania</mods:affiliation></affiliation></author><author><name sortKey="Both, Stefan" sort="Both, Stefan" uniqKey="Both S" first="Stefan" last="Both">Stefan Both</name><affiliation><mods:affiliation>Department of Radiation Oncology, University of Pennsylvania, Philadelphia, Pennsylvania</mods:affiliation></affiliation></author><author><name sortKey="Cheville, Andrea" sort="Cheville, Andrea" uniqKey="Cheville A" first="Andrea" last="Cheville">Andrea Cheville</name><affiliation><mods:affiliation>Department of Physical Medicine and Rehabilitation, University of Pennsylvania, Philadelphia, Pennsylvania</mods:affiliation></affiliation></author><author><name sortKey="Harris, Eleanor E R" sort="Harris, Eleanor E R" uniqKey="Harris E" first="Eleanor E. R." last="Harris">Eleanor E. R. Harris</name><affiliation><mods:affiliation>Department of Radiation Oncology, University of Pennsylvania, Philadelphia, Pennsylvania</mods:affiliation></affiliation></author></analytic><monogr></monogr><series><title level="j" type="main">The Breast Journal</title><title level="j" type="alt">BREAST JOURNAL</title><idno type="ISSN">1075-122X</idno><idno type="eISSN">1524-4741</idno><imprint><biblScope unit="vol">18</biblScope><biblScope unit="issue">3</biblScope><biblScope unit="page" from="219">219</biblScope><biblScope unit="page" to="225">225</biblScope><biblScope unit="page-count">7</biblScope><publisher>Blackwell Publishing Ltd</publisher><pubPlace>Oxford, UK</pubPlace><date type="published" when="2012-05">2012-05</date></imprint><idno type="ISSN">1075-122X</idno></series></biblStruct></sourceDesc><seriesStmt><idno type="ISSN">1075-122X</idno></seriesStmt></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract">Abstract: The objective of this study was to describe the progression of arm lymphedema (ALE) after the initial presentation among patients receiving breast conservation therapy for early stage breast cancer and to identify potential risk factors contributing to ALE progression. The study sample was the 266 stage I or II breast cancer patients with documented ALE who underwent breast conservation therapy that included lumpectomy, axillary staging followed by radiation therapy. ALE were graded according to a difference of 0.5–2 cm (mild), 2.1–3 cm (moderate), and >3 cm (severe) in the circumference between the upper extremities for the treated and untreated sides. ALE at presentation was scored as mild, moderate, and severe in 109 (41%), 125 (47%), and 32 (12%) patients, respectively. One third of patients with ALE progressed to a more severe grade of lymphedema at 5 years of follow‐up. Age older than 65 years at the time of breast cancer treatment was associated with higher risk of ALE progression when compared 65 year age or younger (p = 0.04). The patients who had regional lymph node irradiation including posterior axillary boost were at higher risk of lymphedema progression than the patients treated with whole breast irradiation only (p = 0.001). Progression of ALE is a common occurrence. The current study provides support for the utility of routine arm measurements after breast cancer treatment to facilitate timely diagnosis and treatment of ALE.</div></front></TEI><istex><corpusName>wiley</corpusName><keywords><teeft><json:string>lymphedema</json:string><json:string>axillary</json:string><json:string>node</json:string><json:string>supraclavicular</json:string><json:string>lymphedema progression</json:string><json:string>nodal</json:string><json:string>breast cancer</json:string><json:string>posterior axillary</json:string><json:string>progression</json:string><json:string>radiotherapy</json:string><json:string>breast cancer treatment</json:string><json:string>oncol</json:string><json:string>breast conservation therapy</json:string><json:string>breast cancer diagnosis</json:string><json:string>lymph</json:string><json:string>lymphedema development</json:string><json:string>oncology</json:string><json:string>chemotherapy</json:string><json:string>higher risk</json:string><json:string>radiation therapy</json:string><json:string>univariate</json:string><json:string>radiation oncology</json:string><json:string>axillary lymph nodes</json:string><json:string>nodal irradiation</json:string><json:string>supraclavicular irradiation</json:string><json:string>radiat oncol biol phys</json:string><json:string>risk factors</json:string><json:string>breast conservation treatment</json:string><json:string>axillary dissection</json:string><json:string>regional nodal irradiation</json:string><json:string>present address</json:string><json:string>lymphedema diagnosis</json:string><json:string>supraclavicular nodal irradiation</json:string><json:string>breast</json:string><json:string>lymph nodes</json:string><json:string>potential risk factors</json:string><json:string>current study</json:string><json:string>hormonal therapy</json:string><json:string>initial presentation</json:string><json:string>axillary lymph node dissection</json:string><json:string>lymphedema onset</json:string><json:string>breast cancer patients</json:string><json:string>univariate analysis</json:string><json:string>multivariate analysis</json:string><json:string>breast irradiation</json:string><json:string>sentinel lymph node biopsy</json:string><json:string>early stage breast cancer</json:string><json:string>study sample</json:string><json:string>treatment characteristics</json:string><json:string>systemic therapy</json:string><json:string>breast cancer survivors</json:string><json:string>positive axillary lymph nodes</json:string></teeft></keywords><author><json:item><name>Voichita Bar Ad MD</name><affiliations><json:string>Department of Radiation Oncology, University of Pennsylvania, Philadelphia, Pennsylvania</json:string></affiliations></json:item><json:item><name>Pinaki R. Dutta MD</name><affiliations><json:string>Department of Radiation Oncology, University of Pennsylvania, Philadelphia, Pennsylvania</json:string></affiliations></json:item><json:item><name>Lawrence J. Solin MD</name><affiliations><json:string>Department of Radiation Oncology, University of Pennsylvania, Philadelphia, Pennsylvania</json:string></affiliations></json:item><json:item><name>Wei‐Ting Hwang PhD</name><affiliations><json:string>Department of Biostatistics and Epidemiology, University of Pennsylvania, Philadelphia, Pennsylvania</json:string></affiliations></json:item><json:item><name>Kay See Tan PhD</name><affiliations><json:string>Department of Biostatistics and Epidemiology, University of Pennsylvania, Philadelphia, Pennsylvania</json:string></affiliations></json:item><json:item><name>Stefan Both PhD</name><affiliations><json:string>Department of Radiation Oncology, University of Pennsylvania, Philadelphia, Pennsylvania</json:string></affiliations></json:item><json:item><name>Andrea Cheville MD</name><affiliations><json:string>Department of Physical Medicine and Rehabilitation, University of Pennsylvania, Philadelphia, Pennsylvania</json:string></affiliations></json:item><json:item><name>Eleanor E. R. Harris MD</name><affiliations><json:string>Department of Radiation Oncology, University of Pennsylvania, Philadelphia, Pennsylvania</json:string></affiliations></json:item></author><subject><json:item><lang><json:string>eng</json:string></lang><value>arm lymphedema progression</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>breast conservation treatment</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>early stage breast cancer</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>radiation treatment</value></json:item></subject><articleId><json:string>TBJ1229</json:string></articleId><language><json:string>eng</json:string></language><originalGenre><json:string>article</json:string></originalGenre><abstract>Abstract: The objective of this study was to describe the progression of arm lymphedema (ALE) after the initial presentation among patients receiving breast conservation therapy for early stage breast cancer and to identify potential risk factors contributing to ALE progression. The study sample was the 266 stage I or II breast cancer patients with documented ALE who underwent breast conservation therapy that included lumpectomy, axillary staging followed by radiation therapy. ALE were graded according to a difference of 0.5–2 cm (mild), 2.1–3 cm (moderate), and >3 cm (severe) in the circumference between the upper extremities for the treated and untreated sides. ALE at presentation was scored as mild, moderate, and severe in 109 (41%), 125 (47%), and 32 (12%) patients, respectively. One third of patients with ALE progressed to a more severe grade of lymphedema at 5 years of follow‐up. Age older than 65 years at the time of breast cancer treatment was associated with higher risk of ALE progression when compared 65 year age or younger (p = 0.04). The patients who had regional lymph node irradiation including posterior axillary boost were at higher risk of lymphedema progression than the patients treated with whole breast irradiation only (p = 0.001). Progression of ALE is a common occurrence. The current study provides support for the utility of routine arm measurements after breast cancer treatment to facilitate timely diagnosis and treatment of ALE.</abstract><qualityIndicators><score>6.806</score><pdfVersion>1.3</pdfVersion><pdfPageSize>595.276 x 788.031 pts</pdfPageSize><refBibsNative>true</refBibsNative><abstractCharCount>1475</abstractCharCount><pdfWordCount>4142</pdfWordCount><pdfCharCount>26925</pdfCharCount><pdfPageCount>7</pdfPageCount><abstractWordCount>222</abstractWordCount></qualityIndicators><title>Time‐Course of Arm Lymphedema and Potential Risk Factors for Progression of Lymphedema After Breast Conservation Treatment for Early Stage Breast Cancer</title><genre><json:string>article</json:string></genre><host><title>The Breast 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Cancer</title></titleStmt><publicationStmt><publisher>Blackwell Publishing Ltd</publisher><pubPlace>Oxford, UK</pubPlace><availability><licence>© 2012 Wiley Periodicals, Inc.</licence></availability><date type="published" when="2012-05"></date></publicationStmt><notesStmt><note type="content-type" subtype="article" source="article" scheme="https://content-type.data.istex.fr/ark:/67375/XTP-6N5SZHKN-D">article</note><note type="publication-type" subtype="journal" scheme="https://publication-type.data.istex.fr/ark:/67375/JMC-0GLKJH51-B">journal</note></notesStmt><sourceDesc><biblStruct type="article"><analytic><title level="a" type="main">Time‐Course of Arm Lymphedema and Potential Risk Factors for Progression of Lymphedema After Breast Conservation Treatment for Early Stage Breast Cancer</title><title level="a" type="short">Arm Lymphedema Progression</title><author xml:id="author-0000"><persName><forename type="first">Voichita</forename><surname>Bar Ad</surname><roleName type="degree">MD</roleName></persName><affiliation>Department of Radiation Oncology, University of Pennsylvania, Philadelphia, Pennsylvania<address><country key="US"></country></address></affiliation><note type="foot">Present address: Department of Radiation Oncology, Thomas Jefferson University, Philadelphia, Pennsylvania</note></author><author xml:id="author-0001"><persName><forename type="first">Pinaki R.</forename><surname>Dutta</surname><roleName type="degree">MD</roleName></persName><affiliation>Department of Radiation Oncology, University of Pennsylvania, Philadelphia, Pennsylvania<address><country key="US"></country></address></affiliation><note type="foot">Present address: Department of Radiation Oncology, Memorial Sloan‐Kettering Cancer Center, Rockville Centre, New York</note></author><author xml:id="author-0002"><persName><forename type="first">Lawrence J.</forename><surname>Solin</surname><roleName type="degree">MD</roleName></persName><affiliation>Department of Radiation Oncology, University of Pennsylvania, Philadelphia, Pennsylvania<address><country key="US"></country></address></affiliation><note type="foot">Present address: Department of Radiation Oncology, Albert Einstein Medical Center, Philadelphia, Pennsylvania</note></author><author xml:id="author-0003"><persName><forename type="first">Wei‐Ting</forename><surname>Hwang</surname><roleName type="degree">PhD</roleName></persName><affiliation>Department of Biostatistics and Epidemiology, University of Pennsylvania, Philadelphia, Pennsylvania<address><country key="US"></country></address></affiliation></author><author xml:id="author-0004"><persName><forename type="first">Kay See</forename><surname>Tan</surname><roleName type="degree">PhD</roleName></persName><affiliation>Department of Biostatistics and Epidemiology, University of Pennsylvania, Philadelphia, Pennsylvania<address><country key="US"></country></address></affiliation></author><author xml:id="author-0005"><persName><forename type="first">Stefan</forename><surname>Both</surname><roleName type="degree">PhD</roleName></persName><affiliation>Department of Radiation Oncology, University of Pennsylvania, Philadelphia, Pennsylvania<address><country key="US"></country></address></affiliation></author><author xml:id="author-0006"><persName><forename type="first">Andrea</forename><surname>Cheville</surname><roleName type="degree">MD</roleName></persName><affiliation>Department of Physical Medicine and Rehabilitation, University of Pennsylvania, Philadelphia, Pennsylvania<address><country key="US"></country></address></affiliation><note type="foot">Present address: Department of Physical Medicine and Rehabilitation, Mayo Clinic, Rochester, Minnesota</note></author><author xml:id="author-0007"><persName><forename type="first">Eleanor E. R.</forename><surname>Harris</surname><roleName type="degree">MD</roleName></persName><affiliation>Department of Radiation Oncology, University of Pennsylvania, Philadelphia, Pennsylvania<address><country key="US"></country></address></affiliation><note type="foot">Present address: Department of Radiation Oncology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida</note></author><idno type="istex">BAB15772A0327AA731EAEF8A2AD9FD6CCC7C874D</idno><idno type="DOI">10.1111/j.1524-4741.2012.01229.x</idno><idno type="unit">TBJ1229</idno><idno type="toTypesetVersion">file:TBJ.TBJ1229.pdf</idno></analytic><monogr><title level="j" type="main">The Breast Journal</title><title level="j" type="alt">BREAST JOURNAL</title><idno type="pISSN">1075-122X</idno><idno type="eISSN">1524-4741</idno><idno type="book-DOI">10.1111/(ISSN)1524-4741</idno><idno type="book-part-DOI">10.1111/tbj.2012.18.issue-3</idno><idno type="product">TBJ</idno><idno type="publisherDivision">ST</idno><imprint><biblScope unit="vol">18</biblScope><biblScope unit="issue">3</biblScope><biblScope unit="page" from="219">219</biblScope><biblScope unit="page" to="225">225</biblScope><biblScope unit="page-count">7</biblScope><publisher>Blackwell Publishing Ltd</publisher><pubPlace>Oxford, UK</pubPlace><date type="published" when="2012-05"></date></imprint></monogr></biblStruct></sourceDesc></fileDesc><profileDesc><abstract xml:lang="en" style="main"><p><hi rend="bold">Abstract: </hi> The objective of this study was to describe the progression of arm lymphedema (ALE) after the initial presentation among patients receiving breast conservation therapy for early stage breast cancer and to identify potential risk factors contributing to ALE progression. The study sample was the 266 stage I or II breast cancer patients with documented ALE who underwent breast conservation therapy that included lumpectomy, axillary staging followed by radiation therapy. ALE were graded according to a difference of 0.5–2 cm (mild), 2.1–3 cm (moderate), and >3 cm (severe) in the circumference between the upper extremities for the treated and untreated sides. ALE at presentation was scored as mild, moderate, and severe in 109 (41%), 125 (47%), and 32 (12%) patients, respectively. One third of patients with ALE progressed to a more severe grade of lymphedema at 5 years of follow‐up. Age older than 65 years at the time of breast cancer treatment was associated with higher risk of ALE progression when compared 65 year age or younger (p = 0.04). The patients who had regional lymph node irradiation including posterior axillary boost were at higher risk of lymphedema progression than the patients treated with whole breast irradiation only (p = 0.001). Progression of ALE is a common occurrence. The current study provides support for the utility of routine arm measurements after breast cancer treatment to facilitate timely diagnosis and treatment of ALE.</p></abstract><textClass><keywords xml:lang="en"><term xml:id="k1">arm lymphedema progression</term><term xml:id="k2">breast conservation treatment</term><term xml:id="k3">early stage breast cancer</term><term xml:id="k4">radiation treatment</term></keywords><classCode scheme="tocHeading1">ORIGINAL ARTICLES</classCode><classCode scheme="articleCategory">ORIGINAL ARTICLE</classCode></textClass><langUsage><language ident="EN"></language></langUsage></profileDesc></teiHeader></istex:fulltextTEI><json:item><extension>txt</extension><original>false</original><mimetype>text/plain</mimetype><uri>https://api.istex.fr/document/BAB15772A0327AA731EAEF8A2AD9FD6CCC7C874D/fulltext/txt</uri></json:item></fulltext><metadata><istex:metadataXml wicri:clean="Wiley, elements deleted: body"><istex:xmlDeclaration>version="1.0" encoding="UTF-8" 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position="4" status="forIssue"><doi origin="wiley">10.1111/j.1524-4741.2012.01229.x</doi><idGroup><id type="unit" value="TBJ1229"></id></idGroup><countGroup><count type="pageTotal" number="7"></count></countGroup><titleGroup><title type="tocHeading1">ORIGINAL ARTICLES</title><title type="articleCategory">ORIGINAL ARTICLE</title></titleGroup><copyright>© 2012 Wiley Periodicals, Inc.</copyright><eventGroup><event type="xmlConverted" agent="Converter:BPG_TO_WML3G version:3.1.5 mode:FullText" date="2012-05-14"></event><event type="publishedOnlineEarlyUnpaginated" date="2012-04-05"></event><event type="firstOnline" date="2012-04-05"></event><event type="publishedOnlineFinalForm" date="2012-05-14"></event><event type="xmlConverted" agent="Converter:WILEY_ML3G_TO_WILEY_ML3GV2 version:3.8.8" date="2014-02-10"></event><event type="xmlConverted" agent="Converter:WML3G_To_WML3G version:4.3.4 mode:FullText" date="2015-02-25"></event></eventGroup><numberingGroup><numbering type="pageFirst" number="219">219</numbering><numbering type="pageLast" number="225">225</numbering></numberingGroup><correspondenceTo>Address correspondence and reprint requests to: Voichita Bar Ad, MD, Department of Radiation Oncology, Thomas Jefferson University, 111 S. 11th Street, Philadelphia, PA 19107, USA, or e‐mail: <email normalForm="voichita.bar-ad@jeffersonhospital.org">voichita.bar‐ad@jeffersonhospital.org</email></correspondenceTo><linkGroup><link type="toTypesetVersion" href="file:TBJ.TBJ1229.pdf"></link></linkGroup></publicationMeta><contentMeta><countGroup><count type="figureTotal" number="3"></count><count type="tableTotal" number="1"></count></countGroup><titleGroup><title type="main">Time‐Course of Arm Lymphedema and Potential Risk Factors for Progression of Lymphedema After Breast Conservation Treatment for Early Stage Breast Cancer</title><title type="shortAuthors">BAR AD ET AL.</title><title type="short"><i>Arm Lymphedema Progression</i></title></titleGroup><creators><creator creatorRole="author" xml:id="cr1" affiliationRef="#a1" noteRef="#fn1"><personName><givenNames>Voichita</givenNames><familyName>Bar Ad</familyName><degrees>MD</degrees></personName></creator><creator creatorRole="author" xml:id="cr2" affiliationRef="#a1" noteRef="#fn2"><personName><givenNames>Pinaki R.</givenNames><familyName>Dutta</familyName><degrees>MD</degrees></personName></creator><creator creatorRole="author" xml:id="cr3" affiliationRef="#a1" noteRef="#fn3"><personName><givenNames>Lawrence J.</givenNames><familyName>Solin</familyName><degrees>MD</degrees></personName></creator><creator creatorRole="author" xml:id="cr4" affiliationRef="#a2"><personName><givenNames>Wei‐Ting</givenNames><familyName>Hwang</familyName><degrees>PhD</degrees></personName></creator><creator creatorRole="author" xml:id="cr5" affiliationRef="#a2"><personName><givenNames>Kay See</givenNames><familyName>Tan</familyName><degrees>PhD</degrees></personName></creator><creator creatorRole="author" xml:id="cr6" affiliationRef="#a1"><personName><givenNames>Stefan</givenNames><familyName>Both</familyName><degrees>PhD</degrees></personName></creator><creator creatorRole="author" xml:id="cr7" affiliationRef="#a3" noteRef="#fn4"><personName><givenNames>Andrea</givenNames><familyName>Cheville</familyName><degrees>MD</degrees></personName></creator><creator creatorRole="author" xml:id="cr8" affiliationRef="#a1" noteRef="#fn5"><personName><givenNames>Eleanor E. R.</givenNames><familyName>Harris</familyName><degrees>MD</degrees></personName></creator></creators><affiliationGroup><affiliation xml:id="a1" countryCode="US"><unparsedAffiliation>Department of Radiation Oncology, University of Pennsylvania, Philadelphia, Pennsylvania</unparsedAffiliation></affiliation><affiliation xml:id="a2" countryCode="US"><unparsedAffiliation>Department of Biostatistics and Epidemiology, University of Pennsylvania, Philadelphia, Pennsylvania</unparsedAffiliation></affiliation><affiliation xml:id="a3" countryCode="US"><unparsedAffiliation>Department of Physical Medicine and Rehabilitation, University of Pennsylvania, Philadelphia, Pennsylvania</unparsedAffiliation></affiliation></affiliationGroup><keywordGroup xml:lang="en"><keyword xml:id="k1">arm lymphedema progression</keyword><keyword xml:id="k2">breast conservation treatment</keyword><keyword xml:id="k3">early stage breast cancer</keyword><keyword xml:id="k4">radiation treatment</keyword></keywordGroup><abstractGroup><abstract type="main" xml:lang="en"><p><b>Abstract: </b> The objective of this study was to describe the progression of arm lymphedema (ALE) after the initial presentation among patients receiving breast conservation therapy for early stage breast cancer and to identify potential risk factors contributing to ALE progression. The study sample was the 266 stage I or II breast cancer patients with documented ALE who underwent breast conservation therapy that included lumpectomy, axillary staging followed by radiation therapy. ALE were graded according to a difference of 0.5–2 cm (mild), 2.1–3 cm (moderate), and >3 cm (severe) in the circumference between the upper extremities for the treated and untreated sides. ALE at presentation was scored as mild, moderate, and severe in 109 (41%), 125 (47%), and 32 (12%) patients, respectively. One third of patients with ALE progressed to a more severe grade of lymphedema at 5 years of follow‐up. Age older than 65 years at the time of breast cancer treatment was associated with higher risk of ALE progression when compared 65 year age or younger (p = 0.04). The patients who had regional lymph node irradiation including posterior axillary boost were at higher risk of lymphedema progression than the patients treated with whole breast irradiation only (p = 0.001). Progression of ALE is a common occurrence. The current study provides support for the utility of routine arm measurements after breast cancer treatment to facilitate timely diagnosis and treatment of ALE.</p></abstract></abstractGroup></contentMeta><noteGroup><note xml:id="fn1"><p>
Present address: Department of Radiation Oncology, Thomas Jefferson University, Philadelphia, Pennsylvania</p></note><note xml:id="fn2"><p>
Present address: Department of Radiation Oncology, Memorial Sloan‐Kettering Cancer Center, Rockville Centre, New York</p></note><note xml:id="fn3"><p>
Present address: Department of Radiation Oncology, Albert Einstein Medical Center, Philadelphia, Pennsylvania</p></note><note xml:id="fn4"><p>
Present address: Department of Physical Medicine and Rehabilitation, Mayo Clinic, Rochester, Minnesota</p></note><note xml:id="fn5"><p>
Present address: Department of Radiation Oncology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida</p></note><note xml:id="fn6"><p>Presented in part at the American Society for Therapeutic Radiology and Oncology Annual Meeting, Atlanta 2006.</p></note><note xml:id="fn7"><p><b>Disclosure:</b> No conflict of interest. No funds to declare.</p></note></noteGroup></header></component></istex:document></istex:metadataXml><mods version="3.6"><titleInfo lang="en"><title>Time‐Course of Arm Lymphedema and Potential Risk Factors for Progression of Lymphedema After Breast Conservation Treatment for Early Stage Breast Cancer</title></titleInfo><titleInfo type="abbreviated" lang="en"><title>Arm Lymphedema Progression</title></titleInfo><titleInfo type="alternative" contentType="CDATA" lang="en"><title>Time‐Course of Arm Lymphedema and Potential Risk Factors for Progression of Lymphedema After Breast Conservation Treatment for Early Stage Breast Cancer</title></titleInfo><name type="personal"><namePart type="given">Voichita</namePart><namePart type="family">Bar Ad</namePart><namePart type="termsOfAddress">MD</namePart><affiliation>Department of Radiation Oncology, University of Pennsylvania, Philadelphia, Pennsylvania</affiliation><description>Present address: Department of Radiation Oncology, Thomas Jefferson University, Philadelphia, Pennsylvania</description><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Pinaki R.</namePart><namePart type="family">Dutta</namePart><namePart type="termsOfAddress">MD</namePart><affiliation>Department of Radiation Oncology, University of Pennsylvania, Philadelphia, Pennsylvania</affiliation><description>Present address: Department of Radiation Oncology, Memorial Sloan‐Kettering Cancer Center, Rockville Centre, New York</description><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Lawrence J.</namePart><namePart type="family">Solin</namePart><namePart type="termsOfAddress">MD</namePart><affiliation>Department of Radiation Oncology, University of Pennsylvania, Philadelphia, Pennsylvania</affiliation><description>Present address: Department of Radiation Oncology, Albert Einstein Medical Center, Philadelphia, Pennsylvania</description><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Wei‐Ting</namePart><namePart type="family">Hwang</namePart><namePart type="termsOfAddress">PhD</namePart><affiliation>Department of Biostatistics and Epidemiology, University of Pennsylvania, Philadelphia, Pennsylvania</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Kay See</namePart><namePart type="family">Tan</namePart><namePart type="termsOfAddress">PhD</namePart><affiliation>Department of Biostatistics and Epidemiology, University of Pennsylvania, Philadelphia, Pennsylvania</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Stefan</namePart><namePart type="family">Both</namePart><namePart type="termsOfAddress">PhD</namePart><affiliation>Department of Radiation Oncology, University of Pennsylvania, Philadelphia, Pennsylvania</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Andrea</namePart><namePart type="family">Cheville</namePart><namePart type="termsOfAddress">MD</namePart><affiliation>Department of Physical Medicine and Rehabilitation, University of Pennsylvania, Philadelphia, Pennsylvania</affiliation><description>Present address: Department of Physical Medicine and Rehabilitation, Mayo Clinic, Rochester, Minnesota</description><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Eleanor E. R.</namePart><namePart type="family">Harris</namePart><namePart type="termsOfAddress">MD</namePart><affiliation>Department of Radiation Oncology, University of Pennsylvania, Philadelphia, Pennsylvania</affiliation><description>Present address: Department of Radiation Oncology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida</description><role><roleTerm type="text">author</roleTerm></role></name><typeOfResource>text</typeOfResource><genre type="article" displayLabel="article"></genre><originInfo><publisher>Blackwell Publishing Ltd</publisher><place><placeTerm type="text">Oxford, UK</placeTerm></place><dateIssued encoding="w3cdtf">2012-05</dateIssued><copyrightDate encoding="w3cdtf">2012</copyrightDate></originInfo><language><languageTerm type="code" authority="rfc3066">en</languageTerm><languageTerm type="code" authority="iso639-2b">eng</languageTerm></language><physicalDescription><internetMediaType>text/html</internetMediaType><extent unit="figures">3</extent><extent unit="tables">1</extent></physicalDescription><abstract>Abstract: The objective of this study was to describe the progression of arm lymphedema (ALE) after the initial presentation among patients receiving breast conservation therapy for early stage breast cancer and to identify potential risk factors contributing to ALE progression. The study sample was the 266 stage I or II breast cancer patients with documented ALE who underwent breast conservation therapy that included lumpectomy, axillary staging followed by radiation therapy. ALE were graded according to a difference of 0.5–2 cm (mild), 2.1–3 cm (moderate), and >3 cm (severe) in the circumference between the upper extremities for the treated and untreated sides. ALE at presentation was scored as mild, moderate, and severe in 109 (41%), 125 (47%), and 32 (12%) patients, respectively. One third of patients with ALE progressed to a more severe grade of lymphedema at 5 years of follow‐up. Age older than 65 years at the time of breast cancer treatment was associated with higher risk of ALE progression when compared 65 year age or younger (p = 0.04). The patients who had regional lymph node irradiation including posterior axillary boost were at higher risk of lymphedema progression than the patients treated with whole breast irradiation only (p = 0.001). Progression of ALE is a common occurrence. The current study provides support for the utility of routine arm measurements after breast cancer treatment to facilitate timely diagnosis and treatment of ALE.</abstract><subject lang="en"><genre>keywords</genre><topic>arm lymphedema progression</topic><topic>breast conservation treatment</topic><topic>early stage breast cancer</topic><topic>radiation treatment</topic></subject><relatedItem type="host"><titleInfo><title>The Breast Journal</title></titleInfo><genre type="journal">journal</genre><subject><genre>article-category</genre><topic>ORIGINAL ARTICLE</topic></subject><identifier type="ISSN">1075-122X</identifier><identifier type="eISSN">1524-4741</identifier><identifier type="DOI">10.1111/(ISSN)1524-4741</identifier><identifier type="PublisherID">TBJ</identifier><part><date>2012</date><detail type="volume"><caption>vol.</caption><number>18</number></detail><detail type="issue"><caption>no.</caption><number>3</number></detail><extent unit="pages"><start>219</start><end>225</end><total>7</total></extent></part></relatedItem><identifier type="istex">BAB15772A0327AA731EAEF8A2AD9FD6CCC7C874D</identifier><identifier type="DOI">10.1111/j.1524-4741.2012.01229.x</identifier><identifier type="ArticleID">TBJ1229</identifier><accessCondition type="use and reproduction" contentType="copyright">© 2012 Wiley Periodicals, Inc.</accessCondition><recordInfo><recordContentSource>WILEY</recordContentSource><recordOrigin>Blackwell Publishing Ltd</recordOrigin></recordInfo></mods></metadata><serie></serie></istex></record>Pour manipuler ce document sous Unix (Dilib)
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