Factors Associated With the Development of Breast Cancer-Related Lymphedema After Whole-Breast Irradiation
Identifieur interne : 000101 ( PascalFrancis/Checkpoint ); précédent : 000100; suivant : 000102Factors 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.
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- Pascal (Inist)
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- topic : Irradiation.
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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 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 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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></titleStmt><publicationStmt><idno type="wicri:source">INIST</idno><idno type="inist">12-0296896</idno><date when="2012">2012</date><idno type="stanalyst">PASCAL 12-0296896 INIST</idno><idno type="RBID">Pascal:12-0296896</idno><idno type="wicri:Area/PascalFrancis/Corpus">000083</idno><idno type="wicri:Area/PascalFrancis/Curation">000874</idno><idno type="wicri:Area/PascalFrancis/Checkpoint">000101</idno><idno type="wicri:explorRef" wicri:stream="PascalFrancis" wicri:step="Checkpoint">000101</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a">Factors Associated With the Development of Breast Cancer-Related Lymphedema After Whole-Breast Irradiation</title><author><name sortKey="Shah, Chirag" sort="Shah, Chirag" uniqKey="Shah C" first="Chirag" last="Shah">Chirag Shah</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="Wilkinson, John Ben" sort="Wilkinson, John Ben" uniqKey="Wilkinson J" first="John Ben" last="Wilkinson">John Ben 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><inist><standard h6="B"><pA><fA01 i1="01" i2="1"><s0>0360-3016</s0></fA01><fA02 i1="01"><s0>IOBPD3</s0></fA02><fA03 i2="1"><s0>Int. j. radiat. oncol. biol. phys.</s0></fA03><fA05><s2>83</s2></fA05><fA06><s2>4</s2></fA06><fA08 i1="01" i2="1" l="ENG"><s1>Factors Associated With the Development of Breast Cancer-Related Lymphedema After Whole-Breast Irradiation</s1></fA08><fA11 i1="01" i2="1"><s1>SHAH (Chirag)</s1></fA11><fA11 i1="02" i2="1"><s1>WILKINSON (John Ben)</s1></fA11><fA11 i1="03" i2="1"><s1>BASCHNAGEL (Andrew)</s1></fA11><fA11 i1="04" i2="1"><s1>GHILEZAN (Mihai)</s1></fA11><fA11 i1="05" i2="1"><s1>RIUTTA (Justin)</s1></fA11><fA11 i1="06" i2="1"><s1>DEKHNE (Nayana)</s1></fA11><fA11 i1="07" i2="1"><s1>BALARAMAN (Savitha)</s1></fA11><fA11 i1="08" i2="1"><s1>MITCHELL (Christina)</s1></fA11><fA11 i1="09" i2="1"><s1>WALLACE (Michelle)</s1></fA11><fA11 i1="10" i2="1"><s1>VICINI (Frank)</s1></fA11><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></fA14><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></fA14><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></fA14><fA20><s1>1095-1100</s1></fA20><fA21><s1>2012</s1></fA21><fA23 i1="01"><s0>ENG</s0></fA23><fA43 i1="01"><s1>INIST</s1><s2>17180</s2><s5>354000506609020060</s5></fA43><fA44><s0>0000</s0><s1>© 2012 INIST-CNRS. All rights reserved.</s1></fA44><fA45><s0>18 ref.</s0></fA45><fA47 i1="01" i2="1"><s0>12-0296896</s0></fA47><fA60><s1>P</s1></fA60><fA61><s0>A</s0></fA61><fA64 i1="01" i2="1"><s0>International journal of radiation oncology, biology, physics</s0></fA64><fA66 i1="01"><s0>USA</s0></fA66><fC01 i1="01" l="ENG"><s0>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.</s0></fC01><fC02 i1="01" i2="X"><s0>002B20E02</s0></fC02><fC02 i1="02" i2="X"><s0>002B12B04</s0></fC02><fC03 i1="01" i2="X" l="FRE"><s0>Cancer du sein</s0><s2>NM</s2><s5>01</s5></fC03><fC03 i1="01" i2="X" l="ENG"><s0>Breast cancer</s0><s2>NM</s2><s5>01</s5></fC03><fC03 i1="01" i2="X" l="SPA"><s0>Cáncer del pecho</s0><s2>NM</s2><s5>01</s5></fC03><fC03 i1="02" i2="X" l="FRE"><s0>Lymphoedème</s0><s5>02</s5></fC03><fC03 i1="02" i2="X" l="ENG"><s0>Lymphedema</s0><s5>02</s5></fC03><fC03 i1="02" i2="X" l="SPA"><s0>Linfedema</s0><s5>02</s5></fC03><fC03 i1="03" i2="X" l="FRE"><s0>Chimiothérapie</s0><s5>04</s5></fC03><fC03 i1="03" i2="X" l="ENG"><s0>Chemotherapy</s0><s5>04</s5></fC03><fC03 i1="03" i2="X" l="SPA"><s0>Quimioterapia</s0><s5>04</s5></fC03><fC03 i1="04" i2="X" l="FRE"><s0>Glande mammaire</s0><s5>07</s5></fC03><fC03 i1="04" i2="X" l="ENG"><s0>Mammary gland</s0><s5>07</s5></fC03><fC03 i1="04" i2="X" l="SPA"><s0>Glándula mamaria</s0><s5>07</s5></fC03><fC03 i1="05" i2="X" l="FRE"><s0>Sein</s0><s5>08</s5></fC03><fC03 i1="05" i2="X" l="ENG"><s0>Breast</s0><s5>08</s5></fC03><fC03 i1="05" i2="X" l="SPA"><s0>Seno</s0><s5>08</s5></fC03><fC03 i1="06" i2="X" l="FRE"><s0>Irradiation</s0><s5>09</s5></fC03><fC03 i1="06" i2="X" l="ENG"><s0>Irradiation</s0><s5>09</s5></fC03><fC03 i1="06" i2="X" l="SPA"><s0>Irradiación</s0><s5>09</s5></fC03><fC03 i1="07" i2="X" l="FRE"><s0>Facteur prédictif</s0><s5>13</s5></fC03><fC03 i1="07" i2="X" l="ENG"><s0>Predictive factor</s0><s5>13</s5></fC03><fC03 i1="07" i2="X" l="SPA"><s0>Factor predictivo</s0><s5>13</s5></fC03><fC03 i1="08" i2="X" l="FRE"><s0>Cancérologie</s0><s5>15</s5></fC03><fC03 i1="08" i2="X" l="ENG"><s0>Cancerology</s0><s5>15</s5></fC03><fC03 i1="08" i2="X" l="SPA"><s0>Cancerología</s0><s5>15</s5></fC03><fC07 i1="01" i2="X" l="FRE"><s0>Traitement</s0></fC07><fC07 i1="01" i2="X" l="ENG"><s0>Treatment</s0></fC07><fC07 i1="01" i2="X" l="SPA"><s0>Tratamiento</s0></fC07><fC07 i1="02" i2="X" l="FRE"><s0>Tumeur maligne</s0><s2>NM</s2><s5>37</s5></fC07><fC07 i1="02" i2="X" l="ENG"><s0>Malignant tumor</s0><s2>NM</s2><s5>37</s5></fC07><fC07 i1="02" i2="X" l="SPA"><s0>Tumor maligno</s0><s2>NM</s2><s5>37</s5></fC07><fC07 i1="03" i2="X" l="FRE"><s0>Cancer</s0><s2>NM</s2></fC07><fC07 i1="03" i2="X" l="ENG"><s0>Cancer</s0><s2>NM</s2></fC07><fC07 i1="03" i2="X" l="SPA"><s0>Cáncer</s0><s2>NM</s2></fC07><fC07 i1="04" i2="X" l="FRE"><s0>Pathologie de la glande mammaire</s0><s2>NM</s2><s5>38</s5></fC07><fC07 i1="04" i2="X" l="ENG"><s0>Mammary gland diseases</s0><s2>NM</s2><s5>38</s5></fC07><fC07 i1="04" i2="X" l="SPA"><s0>Glándula mamaria patología</s0><s2>NM</s2><s5>38</s5></fC07><fC07 i1="05" i2="X" l="FRE"><s0>Pathologie du sein</s0><s2>NM</s2><s5>39</s5></fC07><fC07 i1="05" i2="X" l="ENG"><s0>Breast disease</s0><s2>NM</s2><s5>39</s5></fC07><fC07 i1="05" i2="X" l="SPA"><s0>Seno patología</s0><s2>NM</s2><s5>39</s5></fC07><fC07 i1="06" i2="X" l="FRE"><s0>Pathologie de l'appareil circulatoire</s0><s5>40</s5></fC07><fC07 i1="06" i2="X" l="ENG"><s0>Cardiovascular disease</s0><s5>40</s5></fC07><fC07 i1="06" i2="X" l="SPA"><s0>Aparato circulatorio patología</s0><s5>40</s5></fC07><fC07 i1="07" i2="X" l="FRE"><s0>Pathologie des vaisseaux lymphatiques</s0><s5>41</s5></fC07><fC07 i1="07" i2="X" l="ENG"><s0>Lymphatic vessel disease</s0><s5>41</s5></fC07><fC07 i1="07" i2="X" l="SPA"><s0>Linfático patología</s0><s5>41</s5></fC07><fN21><s1>226</s1></fN21><fN44 i1="01"><s1>OTO</s1></fN44><fN82><s1>OTO</s1></fN82></pA></standard></inist><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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