Breast cancer-related lymphedema rates after modern axillary treatments: How accurate are our estimates? Surgery 2022 Mar;171(3):682-686
Date
11/06/2021Pubmed ID
34736790DOI
10.1016/j.surg.2021.08.019Scopus ID
2-s2.0-85118558521 (requires institutional sign-in at Scopus site) 6 CitationsAbstract
BACKGROUND: Clinical trials have demonstrated methods to minimize the risk of breast cancer-related lymphedema while preserving regional control. We sought to determine the percent lifetime-risk of breast cancer-related lymphedema that surgeons and radiation oncologists discuss with patients before axillary interventions.
METHODS: A nationwide survey of surgeons and radiation oncologists was performed from July to August 2020. Participants were asked to identify what number they discuss with patients when estimating the percent lifetime-risk of breast cancer-related lymphedema after different axillary interventions.
RESULTS: Six hundred and eighty surgeons and 324 radiation oncologists responded (14% response rate). While the estimated rate after sentinel lymph node biopsy was clinically similar between surgeons and radiation oncologists, statistically surgeons quoted a higher percent lifetime-risk (5.7% vs 5.0%, P = .03). Surgeons estimated significantly higher rates of breast cancer-related lymphedema compared with radiation oncologists (P < .001) for axillary lymph node dissection (21.8% vs 17.5%), sentinel lymph node biopsy with regional nodal irradiation (14.1% vs 11.2%), and axillary lymph node dissection with regional nodal irradiation (34.8% vs 26.2%).
CONCLUSION: There is variability in the estimated rates of breast cancer-related lymphedema providers discuss with patients. These findings highlight the need for physician education on the current evidence of percent lifetime-risk of breast cancer-related lymphedema to provide patients with accurate estimates before axillary interventions.
Author List
Cortina CS, Yen TWF, Bergom C, Fields B, Craft MA, Currey A, Kong ALAuthors
Chandler S. Cortina MD Associate Professor in the Surgery department at Medical College of WisconsinAmanda L. Kong MD, MS Professor in the Surgery department at Medical College of Wisconsin
Tina W F Yen MD, MS Professor in the Surgery department at Medical College of Wisconsin
MESH terms used to index this publication - Major topics in bold
AdultAttitude of Health Personnel
Axilla
Breast Neoplasms
Cohort Studies
Cross-Sectional Studies
Humans
Lymph Node Excision
Lymphedema
Middle Aged
Practice Patterns, Physicians'
Radiation Oncology
Risk
Surgical Oncology
Surveys and Questionnaires
United States
