Risk of lymphedema after mastectomy: potential benefit of applying ACOSOG Z0011 protocol to mastectomy patients.
Identifieur interne : 001281 ( PubMed/Checkpoint ); précédent : 001280; suivant : 001282Risk of lymphedema after mastectomy: potential benefit of applying ACOSOG Z0011 protocol to mastectomy patients.
Auteurs : Cynthia L. Miller [États-Unis] ; Michelle C. Specht ; Melissa N. Skolny ; Nora Horick ; Lauren S. Jammallo ; Jean O'Toole ; Mina N. Shenouda ; Betro T. Sadek ; Barbara L. Smith ; Alphonse G. TaghianSource :
- Breast cancer research and treatment [ 1573-7217 ] ; 2014.
Descripteurs français
- KwdFr :
- Adulte, Adulte d'âge moyen, Biopsie de noeud lymphatique sentinelle (effets indésirables), Facteurs de risque, Femelle, Humains, Incidence, Jeune adulte, Lymphoedème (épidémiologie), Mastectomie (effets indésirables), Modèles de hasards proportionnels, Protocoles antinéoplasiques, Radiothérapie (effets indésirables), Sujet âgé, Sujet âgé de 80 ans ou plus, Tumeurs du sein (), Tumeurs du sein (radiothérapie).
- MESH :
- effets indésirables : Biopsie de noeud lymphatique sentinelle, Mastectomie, Radiothérapie.
- radiothérapie : Tumeurs du sein.
- épidémiologie : Lymphoedème.
- Adulte, Adulte d'âge moyen, Facteurs de risque, Femelle, Humains, Incidence, Jeune adulte, Modèles de hasards proportionnels, Protocoles antinéoplasiques, Sujet âgé, Sujet âgé de 80 ans ou plus, Tumeurs du sein.
English descriptors
- KwdEn :
- Adult, Aged, Aged, 80 and over, Antineoplastic Protocols, Breast Neoplasms (radiotherapy), Breast Neoplasms (surgery), Female, Humans, Incidence, Lymphedema (epidemiology), Mastectomy (adverse effects), Middle Aged, Proportional Hazards Models, Radiotherapy (adverse effects), Risk Factors, Sentinel Lymph Node Biopsy (adverse effects), Young Adult.
- MESH :
- adverse effects : Mastectomy, Radiotherapy, Sentinel Lymph Node Biopsy.
- epidemiology : Lymphedema.
- radiotherapy : Breast Neoplasms.
- surgery : Breast Neoplasms.
- Adult, Aged, Aged, 80 and over, Antineoplastic Protocols, Female, Humans, Incidence, Middle Aged, Proportional Hazards Models, Risk Factors, Young Adult.
Abstract
Axillary lymph node dissection (ALND) and radiation therapy (RT) are commonly recommended for mastectomy patients with positive sentinel lymph node biopsy (SLNB). Effective alternatives to ALND that reduce lymphedema risk are needed. We evaluated rates of lymphedema in mastectomy patients who received SLNB with RT, compared to ALND with or without RT. 627 breast cancer patients who underwent 664 mastectomies between 2005 and 2013 were prospectively screened for lymphedema, median 22.8 months follow-up (range 3.0-86.9). Each mastectomy was categorized as SLNB-no RT, SLNB + RT, ALND-no RT, or ALND + RT. RT included chest wall ± nodal radiation. Perometer arm volume measurements were obtained pre- and post-operatively. Lymphedema was defined as ≥10 % arm volume increase. Kaplan-Meier and Cox regression analyses were performed to determine lymphedema rates and risk factors. Of 664 mastectomies, 52 % (343/664) were SLNB-no RT, 5 % (34/664) SLNB + RT, 9 % (58/664) ALND-no RT, and 34 % (229/664) ALND + RT. The 2 year cumulative lymphedema incidence was 10.0 % (95 % CI 2.6-34.4 %) for SLNB + RT compared with 19.3 % (95 % CI 10.8-33.1 %) for ALND-no RT, and 30.1 % (95 % CI 23.7-37.8 %) for ALND + RT. The lowest cumulative incidence was 2.19 % (95 % CI 0.88-5.40 %) for SLNB-no RT. By multivariate analysis, factors significantly associated with increased lymphedema risk included RT (p = 0.0017), ALND (p = 0.0001), greater number of lymph nodes removed (p = 0.0006), no reconstruction (p = 0.0418), higher BMI (p < 0.0001) and older age (p = 0.0021). In conclusion, avoiding completion ALND and instead receiving SLNB with RT may decrease lymphedema risk in patients requiring mastectomy. Future trials should investigate the safety of applying the ACOSOG Z0011 protocol to mastectomy patients.
DOI: 10.1007/s10549-014-2856-3
PubMed: 24500108
Affiliations:
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pubmed:24500108Le document en format XML
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Specht</name></author><author><name sortKey="Skolny, Melissa N" sort="Skolny, Melissa N" uniqKey="Skolny M" first="Melissa N" last="Skolny">Melissa N. Skolny</name></author><author><name sortKey="Horick, Nora" sort="Horick, Nora" uniqKey="Horick N" first="Nora" last="Horick">Nora Horick</name></author><author><name sortKey="Jammallo, Lauren S" sort="Jammallo, Lauren S" uniqKey="Jammallo L" first="Lauren S" last="Jammallo">Lauren S. Jammallo</name></author><author><name sortKey="O Toole, Jean" sort="O Toole, Jean" uniqKey="O Toole J" first="Jean" last="O'Toole">Jean O'Toole</name></author><author><name sortKey="Shenouda, Mina N" sort="Shenouda, Mina N" uniqKey="Shenouda M" first="Mina N" last="Shenouda">Mina N. Shenouda</name></author><author><name sortKey="Sadek, Betro T" sort="Sadek, Betro T" uniqKey="Sadek B" first="Betro T" last="Sadek">Betro T. 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Miller</name><affiliation wicri:level="1"><nlm:affiliation>Department of Radiation Oncology, Massachusetts General Hospital, 100 Blossom Street, Boston, MA, 02114, USA.</nlm:affiliation><country xml:lang="fr">États-Unis</country><wicri:regionArea>Department of Radiation Oncology, Massachusetts General Hospital, 100 Blossom Street, Boston, MA, 02114</wicri:regionArea><wicri:noRegion>02114</wicri:noRegion></affiliation></author><author><name sortKey="Specht, Michelle C" sort="Specht, Michelle C" uniqKey="Specht M" first="Michelle C" last="Specht">Michelle C. Specht</name></author><author><name sortKey="Skolny, Melissa N" sort="Skolny, Melissa N" uniqKey="Skolny M" first="Melissa N" last="Skolny">Melissa N. Skolny</name></author><author><name sortKey="Horick, Nora" sort="Horick, Nora" uniqKey="Horick N" first="Nora" last="Horick">Nora Horick</name></author><author><name sortKey="Jammallo, Lauren S" sort="Jammallo, Lauren S" uniqKey="Jammallo L" first="Lauren S" last="Jammallo">Lauren S. Jammallo</name></author><author><name sortKey="O Toole, Jean" sort="O Toole, Jean" uniqKey="O Toole J" first="Jean" last="O'Toole">Jean O'Toole</name></author><author><name sortKey="Shenouda, Mina N" sort="Shenouda, Mina N" uniqKey="Shenouda M" first="Mina N" last="Shenouda">Mina N. Shenouda</name></author><author><name sortKey="Sadek, Betro T" sort="Sadek, Betro T" uniqKey="Sadek B" first="Betro T" last="Sadek">Betro T. Sadek</name></author><author><name sortKey="Smith, Barbara L" sort="Smith, Barbara L" uniqKey="Smith B" first="Barbara L" last="Smith">Barbara L. Smith</name></author><author><name sortKey="Taghian, Alphonse G" sort="Taghian, Alphonse G" uniqKey="Taghian A" first="Alphonse G" last="Taghian">Alphonse G. Taghian</name></author></analytic><series><title level="j">Breast cancer research and treatment</title><idno type="eISSN">1573-7217</idno><imprint><date when="2014" type="published">2014</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Adult</term><term>Aged</term><term>Aged, 80 and over</term><term>Antineoplastic Protocols</term><term>Breast Neoplasms (radiotherapy)</term><term>Breast Neoplasms (surgery)</term><term>Female</term><term>Humans</term><term>Incidence</term><term>Lymphedema (epidemiology)</term><term>Mastectomy (adverse effects)</term><term>Middle Aged</term><term>Proportional Hazards Models</term><term>Radiotherapy (adverse effects)</term><term>Risk Factors</term><term>Sentinel Lymph Node Biopsy (adverse effects)</term><term>Young Adult</term></keywords><keywords scheme="KwdFr" xml:lang="fr"><term>Adulte</term><term>Adulte d'âge moyen</term><term>Biopsie de noeud lymphatique sentinelle (effets indésirables)</term><term>Facteurs de risque</term><term>Femelle</term><term>Humains</term><term>Incidence</term><term>Jeune adulte</term><term>Lymphoedème (épidémiologie)</term><term>Mastectomie (effets indésirables)</term><term>Modèles de hasards proportionnels</term><term>Protocoles antinéoplasiques</term><term>Radiothérapie (effets indésirables)</term><term>Sujet âgé</term><term>Sujet âgé de 80 ans ou plus</term><term>Tumeurs du sein ()</term><term>Tumeurs du sein (radiothérapie)</term></keywords><keywords scheme="MESH" qualifier="adverse effects" xml:lang="en"><term>Mastectomy</term><term>Radiotherapy</term><term>Sentinel Lymph Node Biopsy</term></keywords><keywords scheme="MESH" qualifier="effets indésirables" xml:lang="fr"><term>Biopsie de noeud lymphatique sentinelle</term><term>Mastectomie</term><term>Radiothérapie</term></keywords><keywords scheme="MESH" qualifier="epidemiology" xml:lang="en"><term>Lymphedema</term></keywords><keywords scheme="MESH" qualifier="radiotherapy" xml:lang="en"><term>Breast Neoplasms</term></keywords><keywords scheme="MESH" qualifier="radiothérapie" xml:lang="fr"><term>Tumeurs du sein</term></keywords><keywords scheme="MESH" qualifier="surgery" xml:lang="en"><term>Breast Neoplasms</term></keywords><keywords scheme="MESH" qualifier="épidémiologie" xml:lang="fr"><term>Lymphoedème</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Adult</term><term>Aged</term><term>Aged, 80 and over</term><term>Antineoplastic Protocols</term><term>Female</term><term>Humans</term><term>Incidence</term><term>Middle Aged</term><term>Proportional Hazards Models</term><term>Risk Factors</term><term>Young Adult</term></keywords><keywords scheme="MESH" xml:lang="fr"><term>Adulte</term><term>Adulte d'âge moyen</term><term>Facteurs de risque</term><term>Femelle</term><term>Humains</term><term>Incidence</term><term>Jeune adulte</term><term>Modèles de hasards proportionnels</term><term>Protocoles antinéoplasiques</term><term>Sujet âgé</term><term>Sujet âgé de 80 ans ou plus</term><term>Tumeurs du sein</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">Axillary lymph node dissection (ALND) and radiation therapy (RT) are commonly recommended for mastectomy patients with positive sentinel lymph node biopsy (SLNB). Effective alternatives to ALND that reduce lymphedema risk are needed. We evaluated rates of lymphedema in mastectomy patients who received SLNB with RT, compared to ALND with or without RT. 627 breast cancer patients who underwent 664 mastectomies between 2005 and 2013 were prospectively screened for lymphedema, median 22.8 months follow-up (range 3.0-86.9). Each mastectomy was categorized as SLNB-no RT, SLNB + RT, ALND-no RT, or ALND + RT. RT included chest wall ± nodal radiation. Perometer arm volume measurements were obtained pre- and post-operatively. Lymphedema was defined as ≥10 % arm volume increase. Kaplan-Meier and Cox regression analyses were performed to determine lymphedema rates and risk factors. Of 664 mastectomies, 52 % (343/664) were SLNB-no RT, 5 % (34/664) SLNB + RT, 9 % (58/664) ALND-no RT, and 34 % (229/664) ALND + RT. The 2 year cumulative lymphedema incidence was 10.0 % (95 % CI 2.6-34.4 %) for SLNB + RT compared with 19.3 % (95 % CI 10.8-33.1 %) for ALND-no RT, and 30.1 % (95 % CI 23.7-37.8 %) for ALND + RT. The lowest cumulative incidence was 2.19 % (95 % CI 0.88-5.40 %) for SLNB-no RT. By multivariate analysis, factors significantly associated with increased lymphedema risk included RT (p = 0.0017), ALND (p = 0.0001), greater number of lymph nodes removed (p = 0.0006), no reconstruction (p = 0.0418), higher BMI (p < 0.0001) and older age (p = 0.0021). In conclusion, avoiding completion ALND and instead receiving SLNB with RT may decrease lymphedema risk in patients requiring mastectomy. Future trials should investigate the safety of applying the ACOSOG Z0011 protocol to mastectomy patients.</div></front></TEI><pubmed><MedlineCitation Status="MEDLINE" Owner="NLM"><PMID Version="1">24500108</PMID><DateCreated><Year>2014</Year><Month>02</Month><Day>14</Day></DateCreated><DateCompleted><Year>2014</Year><Month>10</Month><Day>01</Day></DateCompleted><DateRevised><Year>2017</Year><Month>02</Month><Day>20</Day></DateRevised><Article PubModel="Print-Electronic"><Journal><ISSN IssnType="Electronic">1573-7217</ISSN><JournalIssue CitedMedium="Internet"><Volume>144</Volume><Issue>1</Issue><PubDate><Year>2014</Year><Month>Feb</Month></PubDate></JournalIssue><Title>Breast cancer research and treatment</Title><ISOAbbreviation>Breast Cancer Res. Treat.</ISOAbbreviation></Journal><ArticleTitle>Risk of lymphedema after mastectomy: potential benefit of applying ACOSOG Z0011 protocol to mastectomy patients.</ArticleTitle><Pagination><MedlinePgn>71-7</MedlinePgn></Pagination><ELocationID EIdType="doi" ValidYN="Y">10.1007/s10549-014-2856-3</ELocationID><Abstract><AbstractText>Axillary lymph node dissection (ALND) and radiation therapy (RT) are commonly recommended for mastectomy patients with positive sentinel lymph node biopsy (SLNB). Effective alternatives to ALND that reduce lymphedema risk are needed. We evaluated rates of lymphedema in mastectomy patients who received SLNB with RT, compared to ALND with or without RT. 627 breast cancer patients who underwent 664 mastectomies between 2005 and 2013 were prospectively screened for lymphedema, median 22.8 months follow-up (range 3.0-86.9). Each mastectomy was categorized as SLNB-no RT, SLNB + RT, ALND-no RT, or ALND + RT. RT included chest wall ± nodal radiation. Perometer arm volume measurements were obtained pre- and post-operatively. Lymphedema was defined as ≥10 % arm volume increase. Kaplan-Meier and Cox regression analyses were performed to determine lymphedema rates and risk factors. Of 664 mastectomies, 52 % (343/664) were SLNB-no RT, 5 % (34/664) SLNB + RT, 9 % (58/664) ALND-no RT, and 34 % (229/664) ALND + RT. The 2 year cumulative lymphedema incidence was 10.0 % (95 % CI 2.6-34.4 %) for SLNB + RT compared with 19.3 % (95 % CI 10.8-33.1 %) for ALND-no RT, and 30.1 % (95 % CI 23.7-37.8 %) for ALND + RT. The lowest cumulative incidence was 2.19 % (95 % CI 0.88-5.40 %) for SLNB-no RT. By multivariate analysis, factors significantly associated with increased lymphedema risk included RT (p = 0.0017), ALND (p = 0.0001), greater number of lymph nodes removed (p = 0.0006), no reconstruction (p = 0.0418), higher BMI (p < 0.0001) and older age (p = 0.0021). In conclusion, avoiding completion ALND and instead receiving SLNB with RT may decrease lymphedema risk in patients requiring mastectomy. Future trials should investigate the safety of applying the ACOSOG Z0011 protocol to mastectomy patients.</AbstractText></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Miller</LastName><ForeName>Cynthia L</ForeName><Initials>CL</Initials><AffiliationInfo><Affiliation>Department of Radiation Oncology, Massachusetts General Hospital, 100 Blossom Street, Boston, MA, 02114, USA.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Specht</LastName><ForeName>Michelle C</ForeName><Initials>MC</Initials></Author><Author ValidYN="Y"><LastName>Skolny</LastName><ForeName>Melissa N</ForeName><Initials>MN</Initials></Author><Author ValidYN="Y"><LastName>Horick</LastName><ForeName>Nora</ForeName><Initials>N</Initials></Author><Author ValidYN="Y"><LastName>Jammallo</LastName><ForeName>Lauren S</ForeName><Initials>LS</Initials></Author><Author ValidYN="Y"><LastName>O'Toole</LastName><ForeName>Jean</ForeName><Initials>J</Initials></Author><Author ValidYN="Y"><LastName>Shenouda</LastName><ForeName>Mina N</ForeName><Initials>MN</Initials></Author><Author ValidYN="Y"><LastName>Sadek</LastName><ForeName>Betro T</ForeName><Initials>BT</Initials></Author><Author ValidYN="Y"><LastName>Smith</LastName><ForeName>Barbara L</ForeName><Initials>BL</Initials></Author><Author ValidYN="Y"><LastName>Taghian</LastName><ForeName>Alphonse G</ForeName><Initials>AG</Initials></Author></AuthorList><Language>eng</Language><GrantList CompleteYN="Y"><Grant><GrantID>P50 CA089393</GrantID><Acronym>CA</Acronym><Agency>NCI NIH HHS</Agency><Country>United States</Country></Grant><Grant><GrantID>R01 CA139118</GrantID><Acronym>CA</Acronym><Agency>NCI NIH HHS</Agency><Country>United States</Country></Grant><Grant><GrantID>P50CA089393</GrantID><Acronym>CA</Acronym><Agency>NCI NIH HHS</Agency><Country>United States</Country></Grant><Grant><GrantID>R01CA139118</GrantID><Acronym>CA</Acronym><Agency>NCI NIH HHS</Agency><Country>United States</Country></Grant></GrantList><PublicationTypeList><PublicationType UI="D016428">Journal Article</PublicationType><PublicationType UI="D052061">Research Support, N.I.H., Extramural</PublicationType></PublicationTypeList><ArticleDate DateType="Electronic"><Year>2014</Year><Month>02</Month><Day>06</Day></ArticleDate></Article><MedlineJournalInfo><Country>Netherlands</Country><MedlineTA>Breast Cancer Res Treat</MedlineTA><NlmUniqueID>8111104</NlmUniqueID><ISSNLinking>0167-6806</ISSNLinking></MedlineJournalInfo><CitationSubset>IM</CitationSubset><CommentsCorrectionsList><CommentsCorrections RefType="Cites"><RefSource>J Clin Oncol. 2008 Nov 10;26(32):5213-9</RefSource><PMID Version="1">18838709</PMID></CommentsCorrections><CommentsCorrections RefType="Cites"><RefSource>Lymphat Res Biol. 2005;3(4):208-17</RefSource><PMID Version="1">16379589</PMID></CommentsCorrections><CommentsCorrections RefType="Cites"><RefSource>Breast Cancer Res Treat. 2012 Aug;135(1):145-52</RefSource><PMID 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UI="Q000601" MajorTopicYN="Y">surgery</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D005260" MajorTopicYN="N">Female</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D006801" MajorTopicYN="N">Humans</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D015994" MajorTopicYN="N">Incidence</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D008209" MajorTopicYN="N">Lymphedema</DescriptorName><QualifierName UI="Q000453" MajorTopicYN="Y">epidemiology</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D008408" MajorTopicYN="N">Mastectomy</DescriptorName><QualifierName UI="Q000009" MajorTopicYN="Y">adverse effects</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D008875" MajorTopicYN="N">Middle Aged</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D016016" MajorTopicYN="N">Proportional Hazards Models</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D011878" MajorTopicYN="N">Radiotherapy</DescriptorName><QualifierName UI="Q000009" MajorTopicYN="Y">adverse effects</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D012307" MajorTopicYN="N">Risk Factors</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D021701" MajorTopicYN="N">Sentinel Lymph Node Biopsy</DescriptorName><QualifierName UI="Q000009" MajorTopicYN="Y">adverse effects</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D055815" MajorTopicYN="N">Young Adult</DescriptorName></MeshHeading></MeshHeadingList><OtherID Source="NLM">NIHMS563666</OtherID><OtherID Source="NLM">PMC4011490</OtherID></MedlineCitation><PubmedData><History><PubMedPubDate PubStatus="received"><Year>2014</Year><Month>01</Month><Day>21</Day></PubMedPubDate><PubMedPubDate PubStatus="accepted"><Year>2014</Year><Month>01</Month><Day>22</Day></PubMedPubDate><PubMedPubDate PubStatus="entrez"><Year>2014</Year><Month>2</Month><Day>7</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="pubmed"><Year>2014</Year><Month>2</Month><Day>7</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="medline"><Year>2014</Year><Month>10</Month><Day>2</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate></History><PublicationStatus>ppublish</PublicationStatus><ArticleIdList><ArticleId IdType="pubmed">24500108</ArticleId><ArticleId IdType="doi">10.1007/s10549-014-2856-3</ArticleId><ArticleId IdType="pmc">PMC4011490</ArticleId><ArticleId IdType="mid">NIHMS563666</ArticleId></ArticleIdList></PubmedData></pubmed><affiliations><list><country><li>États-Unis</li></country></list><tree><noCountry><name sortKey="Horick, Nora" sort="Horick, Nora" uniqKey="Horick N" first="Nora" last="Horick">Nora Horick</name><name sortKey="Jammallo, Lauren S" sort="Jammallo, Lauren S" uniqKey="Jammallo L" first="Lauren S" last="Jammallo">Lauren S. Jammallo</name><name sortKey="O Toole, Jean" sort="O Toole, Jean" uniqKey="O Toole J" first="Jean" last="O'Toole">Jean O'Toole</name><name sortKey="Sadek, Betro T" sort="Sadek, Betro T" uniqKey="Sadek B" first="Betro T" last="Sadek">Betro T. Sadek</name><name sortKey="Shenouda, Mina N" sort="Shenouda, Mina N" uniqKey="Shenouda M" first="Mina N" last="Shenouda">Mina N. Shenouda</name><name sortKey="Skolny, Melissa N" sort="Skolny, Melissa N" uniqKey="Skolny M" first="Melissa N" last="Skolny">Melissa N. Skolny</name><name sortKey="Smith, Barbara L" sort="Smith, Barbara L" uniqKey="Smith B" first="Barbara L" last="Smith">Barbara L. Smith</name><name sortKey="Specht, Michelle C" sort="Specht, Michelle C" uniqKey="Specht M" first="Michelle C" last="Specht">Michelle C. Specht</name><name sortKey="Taghian, Alphonse G" sort="Taghian, Alphonse G" uniqKey="Taghian A" first="Alphonse G" last="Taghian">Alphonse G. Taghian</name></noCountry><country name="États-Unis"><noRegion><name sortKey="Miller, Cynthia L" sort="Miller, Cynthia L" uniqKey="Miller C" first="Cynthia L" last="Miller">Cynthia L. Miller</name></noRegion></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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