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Lymphedema Risk

Posted 10/6/2016

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  Many women who have had breast cancer surgery have had some underarm/axillary lymph nodes removed. Over recent years, many women have only had sentinel node surgery, and their risk is less than those of us who have had a full axillary dissection. It is important to note that a full axillary dissection can translate to a wide range of the number of removed lymph nodes. In non-surgical terms, the surgeon removes a particular section of the underarm area and different women have different numbers of nodes within that segment.

  We have known that women who have had a full axillary dissection and radiation therapy are at the greatest risk of developing lymphedema. We also know that it is a lifetime risk, but a recent study from MGH suggests that the time of greatest risk is between 24 and 36 months post surgery. If you are past this, don't take a complete sigh of relief. I have known women who developed the condition years later, and one woman just spent three days at MGH with an infection related to her long-standing lymphedema--and she is close to ten years post surgery.

  Here is the beginning of a Medscape article and then a link to read more: 

Lymphedema and Breast Cancer: When Is Risk Greatest?


The time course for developing lymphedema depends on the type of breast cancer treatment, but the risk peaks between 24 and 36 months post therapy, regardless of treatment type, according to new research.
Receipt of radiation therapy (RT) is also a key to the timing.
"Lymphedema develops earlier in patients who receive radiation, especially those receiving regional lymph node radiation," said the study's lead author, Susan McDuff, MD, PhD, a resident in radiation oncology at the Massachusetts General Hospital (MGH) Cancer Center in Boston.
Lymphedema can be "an incredibly morbid" complication following treatment for breast cancer and is an ongoing source of anxiety for survivors, she said here at the American Society for Radiation Oncology (ASTRO) 2016 Annual Meeting.
To help patients know when they may be "out of the woods," Dr McDuff and colleagues undertook a cohort study to determine whether there is a period when patients are at greatest risk.
First, they looked at cumulative incidence. The team analyzed the records of 1495 patients seen between 2005 and 2016 in a prospective lymphedema screening program at MGH.
The time it took to reach 5% cumulative incidence by treatment group was 32 months for surgery alone and 15 months for RT(P = .02)

Read more: http://www.medscape.com/viewarticle/869873_print

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