ASBrS 2018: Preventing Lymphedema Related to Breast Cancer
Posted: Friday, May 11, 2018
Early and ongoing screening of lymphatic function using bioimpedance spectroscopy (BIS) to measure extracellular fluid appears to result in significantly lower rates of breast cancer–related lymphedema, according to a study presented at the 2018 American Society of Breast Surgeons (ASBrS) in Orlando (Abstract 404018). The findings, presented by Lyndsey Kilgore, MD, of The University of Kansas Cancer Center, Kansas City, support early prospective screening and intervention for women at high risk for lymphedema related to breast cancer.
“Identifying the appropriate patients at the appropriate time is imperative,” Dr. Kilgore said in an ASBrS press release. “After the disease has progressed, more complex, costly interventions are necessary with less potential for resolving to the baseline measurements.”
The study analyzed 146 women with unilateral cancer from November 2014 to December 2017. These women were receiving high-risk treatments for breast cancer–related lymphedema (axillary lymph node dissection, nodal radiation therapy, and/or taxane chemotherapy). All patients received baseline BIS measurements before surgery and serial postoperative measurements in a routine surveillance model; all of the women had at least 1 year of postoperative follow-up.
Of the patients, 49 (34%) developed subclinical lymphedema by elevated BIS scores, with self-directed treatment initiated. After a home therapy program, 40 had elevated measurements resolved at last follow-up, whereas 9 had continued elevated measurements that required referral to outpatient complete decongestive therapy. Patients with persistent breast cancer–related lymphedema displayed significant nodal burden on final surgical pathology, with nine patients having N2 or N3 disease.
“This study shows that early intervention is crucial in addressing lymphatic changes before they reach clinically apparent levels that are likely to become permanent,” Dr. Kilgore stated.