Five-Year Breast Surgeon Experience in LYMPHA at Time of ALND for Treatment of Clinical T1-4N1-3M0 Breast Cancer
| Autor: | Lisa Spiguel, Julia Marshall, Coy D. Heldermon, Dan Neal, Tracy L. Hollen, Christiana M. Shaw, Fantine Giap, Nancy P. Mendenhall, Derly Munoz, Shannon Blewett, William M. Mendenhall, R.B. Mailhot-Vega, Paul Okunieff, Mark M. Leyngold, Morgan P Cribbin, Mariam W Hanna, Julie A. Bradley, Eric Brooks, Sarah S Virk, Kelly M. Herremans, Pamela Clevenger, Andrea N. Riner, Karen Daily |
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| Rok vydání: | 2021 |
| Předmět: |
medicine.medical_specialty
Breast Neoplasms Article Breast cancer Quality of life Medicine Humans Lymphedema Retrospective Studies Surgeons business.industry Sentinel Lymph Node Biopsy Axillary Lymph Node Dissection Retrospective cohort study medicine.disease Surgery Axilla medicine.anatomical_structure Oncology Propensity score matching Quality of Life Lymph Node Excision Female business Body mass index |
| Zdroj: | Ann Surg Oncol |
| ISSN: | 1534-4681 |
| Popis: | BACKGROUND: Breast cancer-related lymphedema (BCRL) is a source of postoperative morbidity for breast cancer survivors. Lymphatic microsurgical preventive healing approach (LYMPHA) is a technique used to prevent BCRL at the time of axillary lymph node dissection (ALND). We report the 5-year experience of a breast surgeon trained in LYMPHA and investigate the outcomes of patients who underwent LYMPHA following ALND for the treatment of cT1-4N1-3M0 breast cancer. METHODS: A retrospective review of patients with T1-4N1-3M0 breast cancer was performed in patients who underwent ALND with and without LYMPHA. Diagnosis of BCRL was made by certified lymphedema therapists. Descriptive statistics and lymphedema surveillance data were analyzed using results of Fisher’s exact or Wilcoxon rank sum tests. Logistic regression and propensity matching were performed to assess the reduction of BCRL occurrence following LYMPHA. RESULTS: In a 5-year period, 132 patients met inclusion criteria with 76 patients undergoing LYMPHA at the time of ALND and 56 patients undergoing ALND alone. Patients who underwent LYMPHA at the time of ALND were significantly less likely to develop BCRL than those who underwent ALND alone (p=0.045). Risk factors associated with BCRL development were increased patient age (p=0.007), BMI (p=0.003), and, in patients undergoing LYMPHA, the number of positive nodes (p=0.026). CONCLUSIONS: LYMPHA may be successfully employed by breast surgeons trained in lymphatic-venous anastomosis at the time of ALND. While research efforts should continue to focus on the prevention and surveillance of BCRL, LYMPHA remains an option to reduce BCRL and improve patient quality of life. |
| Databáze: | OpenAIRE |
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