Factors Associated With the Development of Breast Cancer-Related Lymphedema After Whole-Breast Irradiation
Identifieur interne : 004944 ( Main/Exploration ); précédent : 004943; suivant : 004945Factors Associated With the Development of Breast Cancer-Related Lymphedema After Whole-Breast Irradiation
Auteurs : Chirag Shah [États-Unis] ; John Ben Wilkinson [États-Unis] ; Andrew Baschnagel [États-Unis] ; Mihai Ghilezan [États-Unis] ; Justin Riutta [États-Unis] ; Nayana Dekhne [États-Unis] ; Savitha Balaraman [États-Unis] ; Christina Mitchell [États-Unis] ; Michelle Wallace [États-Unis] ; Frank Vicini [États-Unis]Source :
- International journal of radiation oncology, biology, physics [ 0360-3016 ] ; 2012.
Descripteurs français
- Pascal (Inist)
- Wicri :
- topic : Irradiation.
English descriptors
- KwdEn :
Abstract
Purpose: To determine the rates of breast cancer-related lymphedema (BCRL) in patients undergoing whole-breast irradiation as part of breast-conserving therapy (BCT) and to identify clinical, pathologic, and treatment factors associated with its development. Methods and Materials: A total of 1,861 patients with breast cancer were treated at William Beaumont Hospital with whole-breast irradiation as part of their BCT from January 1980 to February 2006, with 1,497 patients available for analysis. Determination of BCRL was based on clinical assessment. Differences in clinical, pathologic, and treatment characteristics between patients with BCRL and those without BCRL were evaluated, and the actuarial rates of BCRL by regional irradiation technique were determined. Results: The actuarial rate of any BCRL was 7.4% for the entire cohort and 9.9%, 14.7%, and 8.3% for patients receiving a supraclavicular field, posterior axillary boost, and internal mammary irradiation, respectively. BCRL was more likely to develop in patients with advanced nodal status (11.4% vs. 6.3%, p = 0.001), those who had a greater number of lymph nodes removed (14 nodes) (9.5% vs. 6.0%, p = 0.01), those who had extracapsular extension (13.4% vs. 6.9%, p = 0.009), those with Grade II/III disease (10.8% vs. 2.9%, p < 0.001), and those who received adjuvant chemotherapy (10.5% vs. 6.7%, p = 0.02). Regional irradiation showed small increases in the rates of BCRL (p = not significant). Conclusions: These results suggest that clinically detectable BCRL will develop after traditional BCT in up to 10% of patients. High-risk subgroups include patients with advanced nodal status, those with more nodes removed, and those who receive chemotherapy, with patients receiving regional irradiation showing a trend toward increased rates.
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Hospital</s1><s2>Royal Oak, MI</s2><s3>USA</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>3 aut.</sZ><sZ>4 aut.</sZ><sZ>8 aut.</sZ><sZ>9 aut.</sZ><sZ>10 aut.</sZ></inist:fA14><country>États-Unis</country><placeName><region type="state">Michigan</region></placeName></affiliation><affiliation wicri:level="2"><inist:fA14 i1="02"><s1>Beaumont Cancer Institute, William Beaumont Hospital</s1><s2>Royal Oak, MI</s2><s3>USA</s3><sZ>4 aut.</sZ><sZ>5 aut.</sZ><sZ>6 aut.</sZ><sZ>7 aut.</sZ><sZ>10 aut.</sZ></inist:fA14><country>États-Unis</country><placeName><region type="state">Michigan</region></placeName></affiliation></author><author><name sortKey="Riutta, Justin" sort="Riutta, Justin" uniqKey="Riutta J" first="Justin" last="Riutta">Justin Riutta</name><affiliation wicri:level="2"><inist:fA14 i1="02"><s1>Beaumont Cancer Institute, William Beaumont Hospital</s1><s2>Royal Oak, MI</s2><s3>USA</s3><sZ>4 aut.</sZ><sZ>5 aut.</sZ><sZ>6 aut.</sZ><sZ>7 aut.</sZ><sZ>10 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Wilkinson</name><affiliation wicri:level="2"><inist:fA14 i1="01"><s1>Department of Radiation Oncology, William Beaumont Hospital</s1><s2>Royal Oak, MI</s2><s3>USA</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>3 aut.</sZ><sZ>4 aut.</sZ><sZ>8 aut.</sZ><sZ>9 aut.</sZ><sZ>10 aut.</sZ></inist:fA14><country>États-Unis</country><placeName><region type="state">Michigan</region></placeName></affiliation></author><author><name sortKey="Baschnagel, Andrew" sort="Baschnagel, Andrew" uniqKey="Baschnagel A" first="Andrew" last="Baschnagel">Andrew Baschnagel</name><affiliation wicri:level="2"><inist:fA14 i1="01"><s1>Department of Radiation Oncology, William Beaumont Hospital</s1><s2>Royal Oak, MI</s2><s3>USA</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>3 aut.</sZ><sZ>4 aut.</sZ><sZ>8 aut.</sZ><sZ>9 aut.</sZ><sZ>10 aut.</sZ></inist:fA14><country>États-Unis</country><placeName><region type="state">Michigan</region></placeName></affiliation></author><author><name sortKey="Ghilezan, Mihai" sort="Ghilezan, Mihai" uniqKey="Ghilezan M" first="Mihai" last="Ghilezan">Mihai Ghilezan</name><affiliation wicri:level="2"><inist:fA14 i1="01"><s1>Department of Radiation Oncology, William Beaumont Hospital</s1><s2>Royal Oak, MI</s2><s3>USA</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>3 aut.</sZ><sZ>4 aut.</sZ><sZ>8 aut.</sZ><sZ>9 aut.</sZ><sZ>10 aut.</sZ></inist:fA14><country>États-Unis</country><placeName><region type="state">Michigan</region></placeName></affiliation><affiliation wicri:level="2"><inist:fA14 i1="02"><s1>Beaumont Cancer Institute, William Beaumont Hospital</s1><s2>Royal Oak, MI</s2><s3>USA</s3><sZ>4 aut.</sZ><sZ>5 aut.</sZ><sZ>6 aut.</sZ><sZ>7 aut.</sZ><sZ>10 aut.</sZ></inist:fA14><country>États-Unis</country><placeName><region type="state">Michigan</region></placeName></affiliation></author><author><name sortKey="Riutta, Justin" sort="Riutta, Justin" uniqKey="Riutta J" first="Justin" last="Riutta">Justin Riutta</name><affiliation wicri:level="2"><inist:fA14 i1="02"><s1>Beaumont Cancer Institute, William Beaumont Hospital</s1><s2>Royal Oak, MI</s2><s3>USA</s3><sZ>4 aut.</sZ><sZ>5 aut.</sZ><sZ>6 aut.</sZ><sZ>7 aut.</sZ><sZ>10 aut.</sZ></inist:fA14><country>États-Unis</country><placeName><region type="state">Michigan</region></placeName></affiliation><affiliation wicri:level="2"><inist:fA14 i1="03"><s1>William Beaumont School of Medicine, Oakland University</s1><s2>Royal Oak, MI</s2><s3>USA</s3><sZ>5 aut.</sZ><sZ>6 aut.</sZ><sZ>7 aut.</sZ><sZ>10 aut.</sZ></inist:fA14><country>États-Unis</country><placeName><region type="state">Michigan</region></placeName></affiliation></author><author><name sortKey="Dekhne, Nayana" sort="Dekhne, Nayana" uniqKey="Dekhne N" first="Nayana" last="Dekhne">Nayana Dekhne</name><affiliation wicri:level="2"><inist:fA14 i1="02"><s1>Beaumont Cancer Institute, William Beaumont Hospital</s1><s2>Royal Oak, MI</s2><s3>USA</s3><sZ>4 aut.</sZ><sZ>5 aut.</sZ><sZ>6 aut.</sZ><sZ>7 aut.</sZ><sZ>10 aut.</sZ></inist:fA14><country>États-Unis</country><placeName><region type="state">Michigan</region></placeName></affiliation><affiliation wicri:level="2"><inist:fA14 i1="03"><s1>William Beaumont School of Medicine, Oakland University</s1><s2>Royal Oak, MI</s2><s3>USA</s3><sZ>5 aut.</sZ><sZ>6 aut.</sZ><sZ>7 aut.</sZ><sZ>10 aut.</sZ></inist:fA14><country>États-Unis</country><placeName><region type="state">Michigan</region></placeName></affiliation></author><author><name sortKey="Balaraman, Savitha" sort="Balaraman, Savitha" uniqKey="Balaraman S" first="Savitha" last="Balaraman">Savitha Balaraman</name><affiliation wicri:level="2"><inist:fA14 i1="02"><s1>Beaumont Cancer Institute, William Beaumont Hospital</s1><s2>Royal Oak, MI</s2><s3>USA</s3><sZ>4 aut.</sZ><sZ>5 aut.</sZ><sZ>6 aut.</sZ><sZ>7 aut.</sZ><sZ>10 aut.</sZ></inist:fA14><country>États-Unis</country><placeName><region type="state">Michigan</region></placeName></affiliation><affiliation wicri:level="2"><inist:fA14 i1="03"><s1>William Beaumont School of Medicine, Oakland University</s1><s2>Royal Oak, MI</s2><s3>USA</s3><sZ>5 aut.</sZ><sZ>6 aut.</sZ><sZ>7 aut.</sZ><sZ>10 aut.</sZ></inist:fA14><country>États-Unis</country><placeName><region type="state">Michigan</region></placeName></affiliation></author><author><name sortKey="Mitchell, Christina" sort="Mitchell, Christina" uniqKey="Mitchell C" first="Christina" last="Mitchell">Christina Mitchell</name><affiliation wicri:level="2"><inist:fA14 i1="01"><s1>Department of Radiation Oncology, William Beaumont Hospital</s1><s2>Royal Oak, MI</s2><s3>USA</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>3 aut.</sZ><sZ>4 aut.</sZ><sZ>8 aut.</sZ><sZ>9 aut.</sZ><sZ>10 aut.</sZ></inist:fA14><country>États-Unis</country><placeName><region type="state">Michigan</region></placeName></affiliation></author><author><name sortKey="Wallace, Michelle" sort="Wallace, Michelle" uniqKey="Wallace M" first="Michelle" last="Wallace">Michelle Wallace</name><affiliation wicri:level="2"><inist:fA14 i1="01"><s1>Department of Radiation Oncology, William Beaumont Hospital</s1><s2>Royal Oak, MI</s2><s3>USA</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>3 aut.</sZ><sZ>4 aut.</sZ><sZ>8 aut.</sZ><sZ>9 aut.</sZ><sZ>10 aut.</sZ></inist:fA14><country>États-Unis</country><placeName><region type="state">Michigan</region></placeName></affiliation></author><author><name sortKey="Vicini, Frank" sort="Vicini, Frank" uniqKey="Vicini F" first="Frank" last="Vicini">Frank Vicini</name><affiliation wicri:level="2"><inist:fA14 i1="01"><s1>Department of Radiation Oncology, William Beaumont Hospital</s1><s2>Royal Oak, MI</s2><s3>USA</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>3 aut.</sZ><sZ>4 aut.</sZ><sZ>8 aut.</sZ><sZ>9 aut.</sZ><sZ>10 aut.</sZ></inist:fA14><country>États-Unis</country><placeName><region type="state">Michigan</region></placeName></affiliation><affiliation wicri:level="2"><inist:fA14 i1="02"><s1>Beaumont Cancer Institute, William Beaumont Hospital</s1><s2>Royal Oak, MI</s2><s3>USA</s3><sZ>4 aut.</sZ><sZ>5 aut.</sZ><sZ>6 aut.</sZ><sZ>7 aut.</sZ><sZ>10 aut.</sZ></inist:fA14><country>États-Unis</country><placeName><region type="state">Michigan</region></placeName></affiliation><affiliation wicri:level="2"><inist:fA14 i1="03"><s1>William Beaumont School of Medicine, Oakland University</s1><s2>Royal Oak, MI</s2><s3>USA</s3><sZ>5 aut.</sZ><sZ>6 aut.</sZ><sZ>7 aut.</sZ><sZ>10 aut.</sZ></inist:fA14><country>États-Unis</country><placeName><region type="state">Michigan</region></placeName></affiliation></author></analytic><series><title level="j" type="main">International journal of radiation oncology, biology, physics</title><title level="j" type="abbreviated">Int. j. radiat. oncol. biol. phys.</title><idno type="ISSN">0360-3016</idno><imprint><date when="2012">2012</date></imprint></series></biblStruct></sourceDesc><seriesStmt><title level="j" type="main">International journal of radiation oncology, biology, physics</title><title level="j" type="abbreviated">Int. j. radiat. oncol. biol. phys.</title><idno type="ISSN">0360-3016</idno></seriesStmt></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Breast</term><term>Breast cancer</term><term>Cancerology</term><term>Chemotherapy</term><term>Irradiation</term><term>Lymphedema</term><term>Mammary gland</term><term>Predictive factor</term></keywords><keywords scheme="Pascal" xml:lang="fr"><term>Cancer du sein</term><term>Lymphoedème</term><term>Chimiothérapie</term><term>Glande mammaire</term><term>Sein</term><term>Irradiation</term><term>Facteur prédictif</term><term>Cancérologie</term></keywords><keywords scheme="Wicri" type="topic" xml:lang="fr"><term>Irradiation</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">Purpose: To determine the rates of breast cancer-related lymphedema (BCRL) in patients undergoing whole-breast irradiation as part of breast-conserving therapy (BCT) and to identify clinical, pathologic, and treatment factors associated with its development. Methods and Materials: A total of 1,861 patients with breast cancer were treated at William Beaumont Hospital with whole-breast irradiation as part of their BCT from January 1980 to February 2006, with 1,497 patients available for analysis. Determination of BCRL was based on clinical assessment. Differences in clinical, pathologic, and treatment characteristics between patients with BCRL and those without BCRL were evaluated, and the actuarial rates of BCRL by regional irradiation technique were determined. Results: The actuarial rate of any BCRL was 7.4% for the entire cohort and 9.9%, 14.7%, and 8.3% for patients receiving a supraclavicular field, posterior axillary boost, and internal mammary irradiation, respectively. BCRL was more likely to develop in patients with advanced nodal status (11.4% vs. 6.3%, p = 0.001), those who had a greater number of lymph nodes removed (14 nodes) (9.5% vs. 6.0%, p = 0.01), those who had extracapsular extension (13.4% vs. 6.9%, p = 0.009), those with Grade II/III disease (10.8% vs. 2.9%, p < 0.001), and those who received adjuvant chemotherapy (10.5% vs. 6.7%, p = 0.02). Regional irradiation showed small increases in the rates of BCRL (p = not significant). Conclusions: These results suggest that clinically detectable BCRL will develop after traditional BCT in up to 10% of patients. High-risk subgroups include patients with advanced nodal status, those with more nodes removed, and those who receive chemotherapy, with patients receiving regional irradiation showing a trend toward increased rates.</div></front></TEI><affiliations><list><country><li>États-Unis</li></country><region><li>Michigan</li></region></list><tree><country name="États-Unis"><region name="Michigan"><name sortKey="Shah, Chirag" sort="Shah, Chirag" uniqKey="Shah C" first="Chirag" last="Shah">Chirag Shah</name></region><name sortKey="Balaraman, Savitha" sort="Balaraman, Savitha" uniqKey="Balaraman S" first="Savitha" last="Balaraman">Savitha Balaraman</name><name sortKey="Balaraman, Savitha" sort="Balaraman, Savitha" uniqKey="Balaraman S" first="Savitha" last="Balaraman">Savitha Balaraman</name><name sortKey="Baschnagel, Andrew" sort="Baschnagel, Andrew" uniqKey="Baschnagel A" first="Andrew" last="Baschnagel">Andrew Baschnagel</name><name sortKey="Dekhne, Nayana" sort="Dekhne, Nayana" uniqKey="Dekhne N" first="Nayana" last="Dekhne">Nayana Dekhne</name><name sortKey="Dekhne, Nayana" sort="Dekhne, Nayana" uniqKey="Dekhne N" first="Nayana" last="Dekhne">Nayana Dekhne</name><name sortKey="Ghilezan, Mihai" sort="Ghilezan, Mihai" uniqKey="Ghilezan M" first="Mihai" last="Ghilezan">Mihai Ghilezan</name><name sortKey="Ghilezan, Mihai" sort="Ghilezan, Mihai" uniqKey="Ghilezan M" first="Mihai" last="Ghilezan">Mihai Ghilezan</name><name sortKey="Mitchell, Christina" sort="Mitchell, Christina" uniqKey="Mitchell C" first="Christina" last="Mitchell">Christina Mitchell</name><name sortKey="Riutta, Justin" sort="Riutta, Justin" uniqKey="Riutta J" first="Justin" last="Riutta">Justin Riutta</name><name sortKey="Riutta, Justin" sort="Riutta, Justin" uniqKey="Riutta J" first="Justin" last="Riutta">Justin Riutta</name><name sortKey="Vicini, Frank" sort="Vicini, Frank" uniqKey="Vicini F" first="Frank" last="Vicini">Frank Vicini</name><name sortKey="Vicini, Frank" sort="Vicini, Frank" uniqKey="Vicini F" first="Frank" last="Vicini">Frank Vicini</name><name sortKey="Vicini, Frank" sort="Vicini, Frank" uniqKey="Vicini F" first="Frank" last="Vicini">Frank Vicini</name><name sortKey="Wallace, Michelle" sort="Wallace, Michelle" uniqKey="Wallace M" first="Michelle" last="Wallace">Michelle Wallace</name><name sortKey="Wilkinson, John Ben" sort="Wilkinson, John Ben" uniqKey="Wilkinson J" first="John Ben" last="Wilkinson">John Ben Wilkinson</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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