LymphedemaV1, Main, Exploration, bibRecord, 009249

Risk of lymphedema after regional nodal irradiation with breast conservation therapy

Identifieur interne : 009249 ( Main/Exploration ); précédent : 009248; suivant : 009250

Risk of lymphedema after regional nodal irradiation with breast conservation therapy

Auteurs : Simon N. Powell [États-Unis] ; Alphonse G. Taghian [États-Unis] ; Lisa A. Kachnic [États-Unis] ; John J. Coen [États-Unis] ; Sherif I. Assaad [États-Unis]

Source :

International journal of radiation oncology, biology, physics [ 0360-3016 ] ; 2003.

RBID : Pascal:03-0290519

Descripteurs français

Pascal (Inist)
- Tumeur maligne, Glande mammaire, Femelle, Homme, Chirurgie conservatrice, Ganglion lymphatique, Radiothérapie, Facteur risque, Postopératoire, Lymphoedème, Classification par stade, Rétrospective, Membre supérieur, Localisation.
Wicri :
- topic : Homme.

English descriptors

KwdEn :
- Conservative surgery, Female, Human, Localization, Lymph node, Lymphedema, Malignant tumor, Mammary gland, Postoperative, Radiotherapy, Retrospective, Risk factor, Stage classification, Upper limb.

Abstract

Purpose: To evaluate the risk factors for lymphedema in patients receiving breast conservation therapy for early-stage breast cancer. Methods and Materials: Between 1982 and 1995, 727 Stage I-II breast cancer patients were treated with breast conservation therapy at Massachusetts General Hospital. A retrospective analysis of the development of persistent arm edema was performed. Lymphedema was defined as a >2-cm difference in forearm circumference compared with the untreated side. The median follow-up was 72 months. Breast and regional nodal irradiation (BRNI) was administered in 32% of the cases and breast irradiation alone in 68%. Results: Persistent arm lymphedema was documented in 21 patients. The 10-year actuarial incidence was 4.1%. The median time to edema was 39 months. The only significant risk factor for lymphedema was BRNI. The 10-year risk was 1.8% for breast irradiation alone vs. 8.9% for BRNI (p = 0.001). The extent of axillary dissection did not predict for lymphedema even within the subgroups of patients defined by the extent of irradiation. Most patients underwent Level I or II dissection. In this subgroup, the lymphedema risk at 10 years was 10.7% for BRNI vs. 1.0% for breast irradiation alone (p = 0.0003). Conclusion: Nodal irradiation was the only significant risk factor for arm lymphedema in patients receiving breast conservation therapy for early-stage breast cancer. Our data suggest that this risk is low with Level WI dissection and breast irradiation. However, even after the addition of radiotherapy to the axilla and supraclavicular fossa, the development of lymphedema was only 1 in 10, lower than generally recognized.

Affiliations:

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Le document en format XML

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<profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Conservative surgery</term>
<term>Female</term>
<term>Human</term>
<term>Localization</term>
<term>Lymph node</term>
<term>Lymphedema</term>
<term>Malignant tumor</term>
<term>Mammary gland</term>
<term>Postoperative</term>
<term>Radiotherapy</term>
<term>Retrospective</term>
<term>Risk factor</term>
<term>Stage classification</term>
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<keywords scheme="Pascal" xml:lang="fr"><term>Tumeur maligne</term>
<term>Glande mammaire</term>
<term>Femelle</term>
<term>Homme</term>
<term>Chirurgie conservatrice</term>
<term>Ganglion lymphatique</term>
<term>Radiothérapie</term>
<term>Facteur risque</term>
<term>Postopératoire</term>
<term>Lymphoedème</term>
<term>Classification par stade</term>
<term>Rétrospective</term>
<term>Membre supérieur</term>
<term>Localisation</term>
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<front><div type="abstract" xml:lang="en">Purpose: To evaluate the risk factors for lymphedema in patients receiving breast conservation therapy for early-stage breast cancer. Methods and Materials: Between 1982 and 1995, 727 Stage I-II breast cancer patients were treated with breast conservation therapy at Massachusetts General Hospital. A retrospective analysis of the development of persistent arm edema was performed. Lymphedema was defined as a >2-cm difference in forearm circumference compared with the untreated side. The median follow-up was 72 months. Breast and regional nodal irradiation (BRNI) was administered in 32% of the cases and breast irradiation alone in 68%. Results: Persistent arm lymphedema was documented in 21 patients. The 10-year actuarial incidence was 4.1%. The median time to edema was 39 months. The only significant risk factor for lymphedema was BRNI. The 10-year risk was 1.8% for breast irradiation alone vs. 8.9% for BRNI (p = 0.001). The extent of axillary dissection did not predict for lymphedema even within the subgroups of patients defined by the extent of irradiation. Most patients underwent Level I or II dissection. In this subgroup, the lymphedema risk at 10 years was 10.7% for BRNI vs. 1.0% for breast irradiation alone (p = 0.0003). Conclusion: Nodal irradiation was the only significant risk factor for arm lymphedema in patients receiving breast conservation therapy for early-stage breast cancer. Our data suggest that this risk is low with Level WI dissection and breast irradiation. However, even after the addition of radiotherapy to the axilla and supraclavicular fossa, the development of lymphedema was only 1 in 10, lower than generally recognized.</div>
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<name sortKey="Kachnic, Lisa A" sort="Kachnic, Lisa A" uniqKey="Kachnic L" first="Lisa A." last="Kachnic">Lisa A. Kachnic</name>
<name sortKey="Taghian, Alphonse G" sort="Taghian, Alphonse G" uniqKey="Taghian A" first="Alphonse G." last="Taghian">Alphonse G. Taghian</name>
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Risk of lymphedema after regional nodal irradiation with breast conservation therapy

Risk of lymphedema after regional nodal irradiation with breast conservation therapy

Source :

Descripteurs français

English descriptors

Abstract

Links toward previous steps (curation, corpus...)

Le document en format XML

Pour manipuler ce document sous Unix (Dilib)

Pour mettre un lien sur cette page dans le réseau Wicri