Researchers have created a new method to predict the risk that a woman will develop lymphedema within five years after lymph nodes are removed as part of breast cancer treatment. Lymphedema is an abnormal buildup of fluid following lymph node removal, specifically in the arm for women with breast cancer who had the axillary or underarm lymph nodes removed (called axillary lymph node dissection). It affects approximately four million patients worldwide, and it's currently very difficult to predict who will develop lymphedema.
This new method uses several risk factors for lymphedema to help predict the chance that an individual patient will develop lymphedema. These factors include age, body mass index (BMI), chemotherapy given in the same arm where the lymph nodes were removed, the number of lymph nodes removed, where on the body radiation therapy was directed, buildup of fluid after surgery (called seroma), infection, and early swelling or edema. Using these factors, researchers created three mathematical models that predict lymphedema risk before surgery, within six months after surgery, and six months or longer after surgery.
Researchers compared the predictions from the models to the actual number of women who developed lymphedema in a group of 1,054 women. They found that the models correctly predicted a patient would develop lymphedema more than 7 out of 10 times.
What this means for patients
“This new method uses readily available clinical factors and allows for quick and easy estimation of individual risks of developing lymphedema after axillary lymph node surgery in women with breast cancer,” said Jose Bevilacqua, MD, PhD, Surgical Oncologist at Hospital Sirio Libanes in Sao Paulo, Brazil. “Knowing the risk of lymphedema can be important information to have when we speak to our patients about axillary lymph node dissection.” Some of these models are available online for doctors and others will be available soon.
Questions to ask the doctor
- Is an axillary lymph node dissection part of my treatment plan?
- What are the risk factors for developing lymphedema?
- Are there steps I can take to reduce my risk?
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