Impact of adjuvant taxane-based chemotherapy on development of breast cancer-related lymphedema: results from a large prospective cohort
Identifieur interne : 000C99 ( Pmc/Curation ); précédent : 000C98; suivant : 000D00Impact of adjuvant taxane-based chemotherapy on development of breast cancer-related lymphedema: results from a large prospective cohort
Auteurs : Meyha N. Swaroop [États-Unis] ; Chantal M. Ferguson [États-Unis] ; Nora K. Horick [États-Unis] ; Melissa N. Skolny [États-Unis] ; Cynthia L. Miller [États-Unis] ; Lauren S. Jammallo [États-Unis] ; Cheryl L. Brunelle [États-Unis] ; Jean A. O Oole [États-Unis] ; Steven J. Isakoff [États-Unis] ; Michelle C. Specht [États-Unis] ; Alphonse G. Taghian [États-Unis]Source :
- Breast Cancer Research and Treatment [ 0167-6806 ] ; 2015.
Abstract
Taxane-based chemotherapy for the treatment of breast cancer is associated with fluid retention in the extremities; however, its association with development of breast cancer-related lymphedema is unclear. We sought to determine if adjuvant taxane-based chemotherapy increased risk of lymphedema or mild swelling of the upper extremity. 1121 patients with unilateral breast cancer were prospectively screened for lymphedema with perometer measurements. Lymphedema was defined as a relative volume change (RVC) of ≥10 % from preoperative baseline. Mild swelling was defined as RVC 5- <10 %. Clinicopathologic characteristics were obtained via medical record review. Kaplan–Meier and Cox proportional hazard analyses were performed to determine lymphedema rates and risk factors. 29 % (324/1121) of patients were treated with adjuvant taxane-based chemotherapy. The 2-year cumulative incidence of lymphedema in the overall cohort was 5.27 %. By multivariate analysis, axillary lymph node dissection (ALND) (
Url:
DOI: 10.1007/s10549-015-3408-1
PubMed: 25940996
PubMed Central: 4432026
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<series><title level="j">Breast Cancer Research and Treatment</title>
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<front><div type="abstract" xml:lang="en"><p>Taxane-based chemotherapy for the treatment of breast cancer is associated with fluid retention in the extremities; however, its association with development of breast cancer-related lymphedema is unclear. We sought to determine if adjuvant taxane-based chemotherapy increased risk of lymphedema or mild swelling of the upper extremity. 1121 patients with unilateral breast cancer were prospectively screened for lymphedema with perometer measurements. Lymphedema was defined as a relative volume change (RVC) of ≥10 % from preoperative baseline. Mild swelling was defined as RVC 5- <10 %. Clinicopathologic characteristics were obtained via medical record review. Kaplan–Meier and Cox proportional hazard analyses were performed to determine lymphedema rates and risk factors. 29 % (324/1121) of patients were treated with adjuvant taxane-based chemotherapy. The 2-year cumulative incidence of lymphedema in the overall cohort was 5.27 %. By multivariate analysis, axillary lymph node dissection (ALND) (<italic>p</italic>
< 0.0001), higher body mass index (<italic>p</italic>
= 0.0007), and older age at surgery (<italic>p</italic>
= 0.04) were significantly associated with increased risk of lymphedema; however, taxane chemotherapy was not significant when compared to no chemotherapy and non-taxane chemotherapy (HR 1.14, <italic>p</italic>
= 0.62; HR 1.56, <italic>p</italic>
= 0.40, respectively). Chemotherapy with docetaxel was significantly associated with mild swelling on multivariate analysis in comparison to both no chemotherapy and non-taxane chemotherapy groups (HR 1.63, <italic>p</italic>
= 0.0098; HR 2.15, <italic>p</italic>
= 0.02, respectively). Patients who receive taxane-based chemotherapy are not at an increased risk of lymphedema compared to patients receiving no chemotherapy or non-taxane adjuvant chemotherapy. Those treated with docetaxel may experience mild swelling, but this does not translate into subsequent lymphedema.
</p>
</div>
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</TEI>
<pmc article-type="research-article"><pmc-dir>properties open_access</pmc-dir>
<front><journal-meta><journal-id journal-id-type="nlm-ta">Breast Cancer Res Treat</journal-id>
<journal-id journal-id-type="iso-abbrev">Breast Cancer Res. Treat</journal-id>
<journal-title-group><journal-title>Breast Cancer Research and Treatment</journal-title>
</journal-title-group>
<issn pub-type="ppub">0167-6806</issn>
<issn pub-type="epub">1573-7217</issn>
<publisher><publisher-name>Springer US</publisher-name>
<publisher-loc>New York</publisher-loc>
</publisher>
</journal-meta>
<article-meta><article-id pub-id-type="pmid">25940996</article-id>
<article-id pub-id-type="pmc">4432026</article-id>
<article-id pub-id-type="publisher-id">3408</article-id>
<article-id pub-id-type="doi">10.1007/s10549-015-3408-1</article-id>
<article-categories><subj-group subj-group-type="heading"><subject>Clinical Trial</subject>
</subj-group>
</article-categories>
<title-group><article-title>Impact of adjuvant taxane-based chemotherapy on development of breast cancer-related lymphedema: results from a large prospective cohort</article-title>
</title-group>
<contrib-group><contrib contrib-type="author"><name><surname>Swaroop</surname>
<given-names>Meyha N.</given-names>
</name>
<xref ref-type="aff" rid="Aff1"></xref>
</contrib>
<contrib contrib-type="author"><name><surname>Ferguson</surname>
<given-names>Chantal M.</given-names>
</name>
<xref ref-type="aff" rid="Aff1"></xref>
</contrib>
<contrib contrib-type="author"><name><surname>Horick</surname>
<given-names>Nora K.</given-names>
</name>
<xref ref-type="aff" rid="Aff2"></xref>
</contrib>
<contrib contrib-type="author"><name><surname>Skolny</surname>
<given-names>Melissa N.</given-names>
</name>
<xref ref-type="aff" rid="Aff1"></xref>
</contrib>
<contrib contrib-type="author"><name><surname>Miller</surname>
<given-names>Cynthia L.</given-names>
</name>
<xref ref-type="aff" rid="Aff1"></xref>
</contrib>
<contrib contrib-type="author"><name><surname>Jammallo</surname>
<given-names>Lauren S.</given-names>
</name>
<xref ref-type="aff" rid="Aff1"></xref>
</contrib>
<contrib contrib-type="author"><name><surname>Brunelle</surname>
<given-names>Cheryl L.</given-names>
</name>
<xref ref-type="aff" rid="Aff3"></xref>
</contrib>
<contrib contrib-type="author"><name><surname>O’Toole</surname>
<given-names>Jean A.</given-names>
</name>
<xref ref-type="aff" rid="Aff3"></xref>
</contrib>
<contrib contrib-type="author"><name><surname>Isakoff</surname>
<given-names>Steven J.</given-names>
</name>
<xref ref-type="aff" rid="Aff4"></xref>
</contrib>
<contrib contrib-type="author"><name><surname>Specht</surname>
<given-names>Michelle C.</given-names>
</name>
<xref ref-type="aff" rid="Aff5"></xref>
</contrib>
<contrib contrib-type="author" corresp="yes"><name><surname>Taghian</surname>
<given-names>Alphonse G.</given-names>
</name>
<address><phone>617-726-6050</phone>
<email>ataghian@partners.org</email>
</address>
<xref ref-type="aff" rid="Aff1"></xref>
</contrib>
<aff id="Aff1"><label></label>
Department of Radiation Oncology, Massachusetts General Hospital, 100 Blossom Street, Boston, MA 02114 USA</aff>
<aff id="Aff2"><label></label>
Department of Biostatistics, Massachusetts General Hospital, Boston, USA</aff>
<aff id="Aff3"><label></label>
Department of Physical and Occupational Therapy, Massachusetts General Hospital, Boston, USA</aff>
<aff id="Aff4"><label></label>
Division of Hematology and Oncology, Massachusetts General Hospital, Boston, USA</aff>
<aff id="Aff5"><label></label>
Division of Surgical Oncology, Massachusetts General Hospital, Boston, USA</aff>
</contrib-group>
<pub-date pub-type="epub"><day>5</day>
<month>5</month>
<year>2015</year>
</pub-date>
<pub-date pub-type="pmc-release"><day>5</day>
<month>5</month>
<year>2015</year>
</pub-date>
<pub-date pub-type="ppub"><year>2015</year>
</pub-date>
<volume>151</volume>
<issue>2</issue>
<fpage>393</fpage>
<lpage>403</lpage>
<history><date date-type="received"><day>22</day>
<month>4</month>
<year>2015</year>
</date>
<date date-type="accepted"><day>24</day>
<month>4</month>
<year>2015</year>
</date>
</history>
<permissions><copyright-statement>© The Author(s) 2015</copyright-statement>
<license license-type="OpenAccess"><license-p><bold>Open Access</bold>
This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International License (http://creativecommons.org/licenses/by-nc/4.0/), which permits any noncommercial use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.</license-p>
</license>
</permissions>
<abstract id="Abs1"><p>Taxane-based chemotherapy for the treatment of breast cancer is associated with fluid retention in the extremities; however, its association with development of breast cancer-related lymphedema is unclear. We sought to determine if adjuvant taxane-based chemotherapy increased risk of lymphedema or mild swelling of the upper extremity. 1121 patients with unilateral breast cancer were prospectively screened for lymphedema with perometer measurements. Lymphedema was defined as a relative volume change (RVC) of ≥10 % from preoperative baseline. Mild swelling was defined as RVC 5- <10 %. Clinicopathologic characteristics were obtained via medical record review. Kaplan–Meier and Cox proportional hazard analyses were performed to determine lymphedema rates and risk factors. 29 % (324/1121) of patients were treated with adjuvant taxane-based chemotherapy. The 2-year cumulative incidence of lymphedema in the overall cohort was 5.27 %. By multivariate analysis, axillary lymph node dissection (ALND) (<italic>p</italic>
< 0.0001), higher body mass index (<italic>p</italic>
= 0.0007), and older age at surgery (<italic>p</italic>
= 0.04) were significantly associated with increased risk of lymphedema; however, taxane chemotherapy was not significant when compared to no chemotherapy and non-taxane chemotherapy (HR 1.14, <italic>p</italic>
= 0.62; HR 1.56, <italic>p</italic>
= 0.40, respectively). Chemotherapy with docetaxel was significantly associated with mild swelling on multivariate analysis in comparison to both no chemotherapy and non-taxane chemotherapy groups (HR 1.63, <italic>p</italic>
= 0.0098; HR 2.15, <italic>p</italic>
= 0.02, respectively). Patients who receive taxane-based chemotherapy are not at an increased risk of lymphedema compared to patients receiving no chemotherapy or non-taxane adjuvant chemotherapy. Those treated with docetaxel may experience mild swelling, but this does not translate into subsequent lymphedema.
</p>
</abstract>
<kwd-group xml:lang="en"><title>Keywords</title>
<kwd>Lymphedema</kwd>
<kwd>Breast cancer</kwd>
<kwd>Taxane chemotherapy</kwd>
<kwd>Arm swelling</kwd>
<kwd>Quality of life</kwd>
</kwd-group>
<custom-meta-group><custom-meta><meta-name>issue-copyright-statement</meta-name>
<meta-value>© Springer Science+Business Media New York 2015</meta-value>
</custom-meta>
</custom-meta-group>
</article-meta>
</front>
</pmc>
</record>
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