Preoperative Risk Factors for Lymphedema in Inflammatory Breast Cancer.
| Autor: | Copeland-Halperin LR; Department of Surgery, Northwell Health, New York, New York., Hyland CJ; Department of Surgery, Mass General Brigham, Boston, Massachusetts., Gadiraju GK; Harvard Medical School, Boston, Massachusetts., Xiang DH; Harvard Medical School, Boston, Massachusetts., Bellon JR; Department of Radiation Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts., Lynce F; Department of Medicine, Dana-Farber Cancer Institute, Boston, Massachusetts., Dey T; Department of Surgery, Brigham and Women's Hospital, Boston, Massachusetts., Troll EP; Department of Breast Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts., Ryan SJ; Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts., Nakhlis F; Department of Surgery, Brigham and Women's Hospital, Boston, Massachusetts., Broyles JM; Department of Surgery, Brigham and Women's Hospital, Boston, Massachusetts. |
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| Jazyk: | angličtina |
| Zdroj: | Journal of reconstructive microsurgery [J Reconstr Microsurg] 2024 May; Vol. 40 (4), pp. 311-317. Date of Electronic Publication: 2023 Sep 26. |
| DOI: | 10.1055/a-2182-1015 |
| Abstrakt: | Background: Prophylactic lymphatic bypass or LYMPHA (LYmphatic Microsurgical Preventive Healing Approach) is increasingly offered to prevent lymphedema following breast cancer treatment, which develops in up to 47% of patients. Previous studies focused on intraoperative and postoperative lymphedema risk factors, which are often unknown preoperatively when the decision to perform LYMPHA is made. This study aims to identify preoperative lymphedema risk factors in the high-risk inflammatory breast cancer (IBC) population. Methods: Retrospective review of our institution's IBC program database was conducted. The primary outcome was self-reported lymphedema development. Multivariable logistic regression analysis was performed to identify preoperative lymphedema risk factors, while controlling for number of lymph nodes removed during axillary lymph node dissection (ALND), number of positive lymph nodes, residual disease on pathology, and need for adjuvant chemotherapy. Results: Of 356 patients with IBC, 134 (mean age: 51 years, range: 22-89 years) had complete data. All 134 patients underwent surgery and radiation. Forty-seven percent of all 356 patients (167/356) developed lymphedema. Obesity (body mass index > 30) (odds ratio [OR]: 2.7, confidence interval [CI]: 1.2-6.4, p = 0.02) and non-white race (OR: 4.5, CI: 1.2-23, p = 0.04) were preoperative lymphedema risk factors. Conclusion: Patients with IBC are high risk for developing lymphedema due to the need for ALND, radiation, and neoadjuvant chemotherapy. This study also identified non-white race and obesity as risk factors. Larger prospective studies should evaluate potential racial disparities in lymphedema development. Due to the high prevalence of lymphedema, LYMPHA should be considered for all patients with IBC. Competing Interests: None declared. (Thieme. All rights reserved.) |
| Databáze: | MEDLINE |
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