Breast Cancer–Related Lymphedema after Neoadjuvant Chemotherapy
Identifieur interne : 002C99 ( Main/Exploration ); précédent : 002C98; suivant : 002D00Breast Cancer–Related Lymphedema after Neoadjuvant Chemotherapy
Auteurs : Myungsoo Kim [Corée du Sud] ; In Hae Park [Corée du Sud] ; Keun Seok Lee [Corée du Sud] ; Jungsil Ro [Corée du Sud] ; So-Youn Jung [Corée du Sud] ; Seeyoun Lee [Corée du Sud] ; Han-Sung Kang [Corée du Sud] ; Eun Sook Lee [Corée du Sud] ; Tae Hyun Kim [Corée du Sud] ; Kwan Ho Cho [Corée du Sud] ; Kyung Hwan Shin [Corée du Sud]Source :
- Cancer Research and Treatment : Official Journal of Korean Cancer Association [ 1598-2998 ] ; 2014.
Abstract
The risk for lymphedema (LE) after neoadjuvant chemotherapy (NCT) in breast cancer patients has not been fully understood thus far. This study is conducted to investigate the incidence and time course of LE after NCT.
A total of 313 patients with clinically node-positive breast cancer who underwent NCT followed by surgery with axillary lymph node (ALN) dissection from 2004 to 2009 were retrospectively analyzed. All patients received breast and supraclavicular radiation therapy (SCRT). The determination of LE was based on both objective and subjective methods, as part of a prospective database.
At a median follow-up of 5.6 years, 132 patients had developed LE: 88 (28%) were grade 1; 42 (13%) were grade 2; and two (1%) were grade 3. The overall 5-year cumulative incidence of LE was 42%. LE first occurred within 6 months after surgery in 62%; 1 year in 77%; 2 years in 91%; and 3 years in 96%. In a multivariate analysis, age (hazard ratio [HR], 1.66; p < 0.01) and the number of dissected ALNs (HR, 1.68; p < 0.01) were independent risk factors for LE. Patients with both of these risk factors showed a significantly higher 5-year cumulative incidence of LE compared with patients with no or one risk factor (61% and 37%, respectively; p < 0.001). The addition of adjuvant chemotherapy did not significantly correlate with LE.
LE after NCT, surgery, and SCRT developed early after treatment, and with a high incidence rate. More frequent surveillance of arm swelling may be necessary in patients after NCT, especially during the first few years of follow-up.
Url:
DOI: 10.4143/crt.2014.079
PubMed: 25544575
PubMed Central: 4506114
Affiliations:
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National Cancer Center, Goyang,<country>Korea</country></nlm:aff><country xml:lang="fr">Corée du Sud</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author><author><name sortKey="Cho, Kwan Ho" sort="Cho, Kwan Ho" uniqKey="Cho K" first="Kwan Ho" last="Cho">Kwan Ho Cho</name><affiliation wicri:level="1"><nlm:aff id="af1-crt-2014-079">Research Institute and Hospital, National Cancer Center, Goyang,<country>Korea</country></nlm:aff><country xml:lang="fr">Corée du Sud</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author><author><name sortKey="Shin, Kyung Hwan" sort="Shin, Kyung Hwan" uniqKey="Shin K" first="Kyung Hwan" last="Shin">Kyung Hwan Shin</name><affiliation wicri:level="1"><nlm:aff id="af1-crt-2014-079">Research Institute and Hospital, National Cancer Center, Goyang,<country>Korea</country></nlm:aff><country xml:lang="fr">Corée du Sud</country><wicri:regionArea># see nlm:aff country 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id="af1-crt-2014-079">Research Institute and Hospital, National Cancer Center, Goyang,<country>Korea</country></nlm:aff><country xml:lang="fr">Corée du Sud</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation><affiliation wicri:level="1"><nlm:aff id="af2-crt-2014-079">Department of Radiation Oncology, Incheon St. Mary’s Hospital, The Catholic University of Korea College of Medicine, Seoul,<country>Korea</country></nlm:aff><country xml:lang="fr">Corée du Sud</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author><author><name sortKey="Park, In Hae" sort="Park, In Hae" uniqKey="Park I" first="In Hae" last="Park">In Hae Park</name><affiliation wicri:level="1"><nlm:aff id="af1-crt-2014-079">Research Institute and Hospital, National Cancer Center, Goyang,<country>Korea</country></nlm:aff><country xml:lang="fr">Corée du Sud</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author><author><name sortKey="Lee, Keun Seok" sort="Lee, Keun Seok" uniqKey="Lee K" first="Keun Seok" last="Lee">Keun Seok Lee</name><affiliation wicri:level="1"><nlm:aff id="af1-crt-2014-079">Research Institute and Hospital, National Cancer Center, Goyang,<country>Korea</country></nlm:aff><country xml:lang="fr">Corée du Sud</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author><author><name sortKey="Ro, Jungsil" sort="Ro, Jungsil" uniqKey="Ro J" first="Jungsil" last="Ro">Jungsil Ro</name><affiliation wicri:level="1"><nlm:aff id="af1-crt-2014-079">Research Institute and Hospital, National Cancer Center, Goyang,<country>Korea</country></nlm:aff><country xml:lang="fr">Corée du Sud</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author><author><name sortKey="Jung, So Youn" sort="Jung, So Youn" uniqKey="Jung S" first="So-Youn" last="Jung">So-Youn Jung</name><affiliation wicri:level="1"><nlm:aff id="af1-crt-2014-079">Research Institute and Hospital, National Cancer Center, Goyang,<country>Korea</country></nlm:aff><country xml:lang="fr">Corée du Sud</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author><author><name sortKey="Lee, Seeyoun" sort="Lee, Seeyoun" uniqKey="Lee S" first="Seeyoun" last="Lee">Seeyoun Lee</name><affiliation wicri:level="1"><nlm:aff id="af1-crt-2014-079">Research Institute and Hospital, National Cancer Center, Goyang,<country>Korea</country></nlm:aff><country xml:lang="fr">Corée du Sud</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author><author><name sortKey="Kang, Han Sung" sort="Kang, Han Sung" uniqKey="Kang H" first="Han-Sung" last="Kang">Han-Sung Kang</name><affiliation wicri:level="1"><nlm:aff id="af1-crt-2014-079">Research Institute and Hospital, National Cancer Center, Goyang,<country>Korea</country></nlm:aff><country xml:lang="fr">Corée du Sud</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author><author><name sortKey="Lee, Eun Sook" sort="Lee, Eun Sook" uniqKey="Lee E" first="Eun Sook" last="Lee">Eun Sook Lee</name><affiliation wicri:level="1"><nlm:aff id="af1-crt-2014-079">Research Institute and Hospital, National Cancer Center, Goyang,<country>Korea</country></nlm:aff><country xml:lang="fr">Corée du Sud</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author><author><name sortKey="Kim, Tae Hyun" sort="Kim, Tae Hyun" uniqKey="Kim T" first="Tae Hyun" last="Kim">Tae Hyun Kim</name><affiliation wicri:level="1"><nlm:aff id="af1-crt-2014-079">Research Institute and Hospital, National Cancer Center, Goyang,<country>Korea</country></nlm:aff><country xml:lang="fr">Corée du Sud</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author><author><name sortKey="Cho, Kwan Ho" sort="Cho, Kwan Ho" uniqKey="Cho K" first="Kwan Ho" last="Cho">Kwan Ho Cho</name><affiliation wicri:level="1"><nlm:aff id="af1-crt-2014-079">Research Institute and Hospital, National Cancer Center, Goyang,<country>Korea</country></nlm:aff><country xml:lang="fr">Corée du Sud</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author><author><name sortKey="Shin, Kyung Hwan" sort="Shin, Kyung Hwan" uniqKey="Shin K" first="Kyung Hwan" last="Shin">Kyung Hwan Shin</name><affiliation wicri:level="1"><nlm:aff id="af1-crt-2014-079">Research Institute and Hospital, National Cancer Center, Goyang,<country>Korea</country></nlm:aff><country xml:lang="fr">Corée du Sud</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author></analytic><series><title level="j">Cancer Research and Treatment : Official Journal of Korean Cancer Association</title><idno type="ISSN">1598-2998</idno><idno type="eISSN">2005-9256</idno><imprint><date when="2014">2014</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><sec><title>Purpose</title><p>The risk for lymphedema (LE) after neoadjuvant chemotherapy (NCT) in breast cancer patients has not been fully understood thus far. This study is conducted to investigate the incidence and time course of LE after NCT.</p></sec><sec><title>Materials and Methods</title><p>A total of 313 patients with clinically node-positive breast cancer who underwent NCT followed by surgery with axillary lymph node (ALN) dissection from 2004 to 2009 were retrospectively analyzed. All patients received breast and supraclavicular radiation therapy (SCRT). The determination of LE was based on both objective and subjective methods, as part of a prospective database.</p></sec><sec><title>Results</title><p>At a median follow-up of 5.6 years, 132 patients had developed LE: 88 (28%) were grade 1; 42 (13%) were grade 2; and two (1%) were grade 3. The overall 5-year cumulative incidence of LE was 42%. LE first occurred within 6 months after surgery in 62%; 1 year in 77%; 2 years in 91%; and 3 years in 96%. In a multivariate analysis, age (hazard ratio [HR], 1.66; p < 0.01) and the number of dissected ALNs (HR, 1.68; p < 0.01) were independent risk factors for LE. Patients with both of these risk factors showed a significantly higher 5-year cumulative incidence of LE compared with patients with no or one risk factor (61% and 37%, respectively; p < 0.001). The addition of adjuvant chemotherapy did not significantly correlate with LE.</p></sec><sec><title>Conclusion</title><p>LE after NCT, surgery, and SCRT developed early after treatment, and with a high incidence rate. More frequent surveillance of arm swelling may be necessary in patients after NCT, especially during the first few years of follow-up.</p></sec></div></front><back><div1 type="bibliography"><listBibl><biblStruct><analytic><author><name sortKey="Disipio, T" uniqKey="Disipio T">T DiSipio</name></author><author><name sortKey="Rye, S" uniqKey="Rye S">S Rye</name></author><author><name sortKey="Newman, B" uniqKey="Newman B">B Newman</name></author><author><name sortKey="Hayes, S" uniqKey="Hayes S">S Hayes</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Kim, M" uniqKey="Kim M">M Kim</name></author><author><name sortKey="Kim, Sw" uniqKey="Kim S">SW Kim</name></author><author><name sortKey="Lee, Su" uniqKey="Lee S">SU Lee</name></author><author><name sortKey="Lee, Nk" uniqKey="Lee N">NK Lee</name></author><author><name sortKey="Jung, Sy" uniqKey="Jung S">SY Jung</name></author><author><name sortKey="Kim, Th" uniqKey="Kim T">TH 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Torpey</name></author><author><name sortKey="Potashnik, Sl" uniqKey="Potashnik S">SL Potashnik</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Hayes, Sc" uniqKey="Hayes S">SC Hayes</name></author><author><name sortKey="Janda, M" uniqKey="Janda M">M Janda</name></author><author><name sortKey="Cornish, B" uniqKey="Cornish B">B Cornish</name></author><author><name sortKey="Battistutta, D" uniqKey="Battistutta D">D Battistutta</name></author><author><name sortKey="Newman, B" uniqKey="Newman B">B Newman</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Boughey, Jc" uniqKey="Boughey J">JC Boughey</name></author><author><name sortKey="Suman, Vj" uniqKey="Suman V">VJ Suman</name></author><author><name sortKey="Mittendorf, Ea" uniqKey="Mittendorf E">EA Mittendorf</name></author><author><name sortKey="Ahrendt, Gm" uniqKey="Ahrendt G">GM Ahrendt</name></author><author><name sortKey="Wilke, Lg" uniqKey="Wilke L">LG Wilke</name></author><author><name sortKey="Taback, B" uniqKey="Taback B">B Taback</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Daveau, C" uniqKey="Daveau C">C Daveau</name></author><author><name sortKey="Stevens, D" uniqKey="Stevens D">D Stevens</name></author><author><name sortKey="Brain, E" uniqKey="Brain E">E Brain</name></author><author><name sortKey="Berges, O" uniqKey="Berges O">O Berges</name></author><author><name sortKey="Villette, S" uniqKey="Villette S">S Villette</name></author><author><name sortKey="Moisson, P" uniqKey="Moisson P">P Moisson</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Le Scodan, R" uniqKey="Le Scodan R">R Le Scodan</name></author><author><name sortKey="Selz, J" uniqKey="Selz J">J Selz</name></author><author><name sortKey="Stevens, D" uniqKey="Stevens D">D Stevens</name></author><author><name sortKey="Bollet, Ma" uniqKey="Bollet M">MA Bollet</name></author><author><name sortKey="De La Lande, B" uniqKey="De La Lande B">B de la Lande</name></author><author><name sortKey="Daveau, C" uniqKey="Daveau C">C Daveau</name></author></analytic></biblStruct></listBibl></div1></back></TEI><affiliations><list><country><li>Corée du Sud</li></country></list><tree><country name="Corée du Sud"><noRegion><name sortKey="Kim, Myungsoo" sort="Kim, Myungsoo" uniqKey="Kim M" first="Myungsoo" last="Kim">Myungsoo Kim</name></noRegion><name sortKey="Cho, Kwan Ho" sort="Cho, Kwan Ho" uniqKey="Cho K" first="Kwan Ho" last="Cho">Kwan Ho Cho</name><name sortKey="Jung, So Youn" sort="Jung, So Youn" uniqKey="Jung S" first="So-Youn" last="Jung">So-Youn Jung</name><name sortKey="Kang, Han Sung" sort="Kang, Han Sung" uniqKey="Kang H" first="Han-Sung" last="Kang">Han-Sung Kang</name><name sortKey="Kim, Myungsoo" sort="Kim, Myungsoo" uniqKey="Kim M" first="Myungsoo" last="Kim">Myungsoo Kim</name><name sortKey="Kim, Tae Hyun" sort="Kim, Tae Hyun" uniqKey="Kim T" first="Tae Hyun" last="Kim">Tae Hyun Kim</name><name sortKey="Lee, Eun Sook" sort="Lee, Eun Sook" uniqKey="Lee E" first="Eun Sook" last="Lee">Eun Sook Lee</name><name sortKey="Lee, Keun Seok" sort="Lee, Keun Seok" uniqKey="Lee K" first="Keun Seok" last="Lee">Keun Seok Lee</name><name sortKey="Lee, Seeyoun" sort="Lee, Seeyoun" uniqKey="Lee S" first="Seeyoun" last="Lee">Seeyoun Lee</name><name sortKey="Park, In Hae" sort="Park, In Hae" uniqKey="Park I" first="In Hae" last="Park">In Hae Park</name><name sortKey="Ro, Jungsil" sort="Ro, Jungsil" uniqKey="Ro J" first="Jungsil" last="Ro">Jungsil Ro</name><name sortKey="Shin, Kyung Hwan" sort="Shin, Kyung Hwan" uniqKey="Shin K" first="Kyung Hwan" last="Shin">Kyung Hwan Shin</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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