[Medscape] Breast density predicts risk of lymphedema in cancer


NEW YORK (Reuters Health) – In breast cancer patients undergoing axillary lymph node dissection, breast density on mammograms is one of the factors associated with increased risk of edema, according to a new study. lymph.

Dr. Fei-Fei Liu of Princess Margaret Cancer Center, in Toronto, Canada, told Reuters Health via email: “Currently, about a third of patients are diagnosed with late-stage lymphedema with very few options. Choose effective treatment. “We developed a mathematical model to predict the incidence of lymphedema. Patients with low breast density have a higher risk of severe lymphedema.”

In an article in the journal JAMA Network Open, Dr. Liu and colleagues note that lymphedema is a surgical complication in about 20% of breast cancer patients who have had axillary lymph node dissection. This risk nearly doubles when surgery is combined with radiation or chemotherapy.

Furthermore, the condition becomes increasingly difficult to treat over time as fibrosis progresses.

“Most lymphedema risk models are based on cancer risk factors and treatment, but these characteristics do not fully account for risk,” Dr. Liu and her colleagues write.

To investigate further, the researchers examined the data of 373 women with an average age of 52.3 years. All completed their treatment after being first diagnosed with breast cancer. They were divided into an intervention group of 247 and a control group of 126.

Multivariable linear regression revealed that age, BMI and breast density on mammogram were among the independent prognostic factors associated with lymphedema. This is also the case with pathological lymph node counts and axillary lymph node dissection.

In the control trial, there was a moderate but statistically significant correlation between the measured and predicted volumes of lymphedema. The area under the curve was 0.72 for predicting mild lymphedema and 0.83 for severe lymphedema.

The team concluded as follows: “The study results showed that breast fullness was associated with more severe lymphedema, and on multivariate analysis, breast density increased a toxic prognostic value. established in addition to BMI”.

Dr. Liu added, “Determining who is at higher risk with this model could help high-risk patients identify and treat lymphedema earlier, when current treatments are effective. most fruitful.”

Dr. Maggie Lee DiNome of the University of California, Los Angeles, co-author of an editorial, told Reuters Health by email, “The most important observation from this study is mammographic breast density, a standard Consistently reported and easily assessed on each mammogram report may be a useful predictor of lymphedema risk for patients undergoing breast cancer treatment. “

“Until we can completely prevent this potentially disabling side effect, we need to be able to more accurately advise patients about the risks,” she concludes.


1. Repurposing the Mammographic Breast Density Category for Predicting Lymphedema Risk in Patients With Breast Cancer

Maggie Lee DiNome, MD


2. Development and Validation of a Risk Model for Breast Cancer–Related Lymphedema

Jennifer Yin Yee Kwan, MD; Petra Famiyeh; Jie Su, MSc; et alWei Xu, PhD; Benjamin Yin Ming Kwan, MD; Jennifer M. Jones, PhD; Eugene Chang, MD; Kenneth W. Yip, PhD; Fei Fei Liu, MD


SOURCE: https://bit.ly/3nwF2YW and https://bit.ly/36E7D7z JAMA Network Open, online November 11, 2020.

Self-translated article by Ykhoa.org, please do not reup!

Source: Medscape

Link: https://www.medscape.com/viewarticle/941208

Author: Roxie Duong

Edit: Duong Ngoc

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