Skip to main content
Top
Published in: Breast Cancer Research and Treatment 2/2008

01-07-2008 | Clinical Trial

Lymphedema in women with breast cancer: characteristics of patients screened for a randomized trial

Authors: Ian S. Dayes, Mark N. Levine, J. A. Julian, Kathleen I. Pritchard, David P. D’Souza, Lyn Kligman, Donnalue Reise, Jennifer A. Wiernikowski, L. Bonilla, T. J. Whelan

Published in: Breast Cancer Research and Treatment | Issue 2/2008

Login to get access

Abstract

Introduction

Accrual rates for a randomized trial of decongestive therapy in breast cancer patients with lymphedema were lower than anticipated. In two centres, patients presenting to lymphedema clinic were screened for eligibility to understand the accrual process and help define the patient population.

Materials and methods

All breast cancer patients presenting to two lymphedema clinics in regional cancer centres were screened for study entry. Circumferential arm measurements were taken and volumes calculated. Patients were then screened for trial eligibility. All report forms were sent to the trial coordinating centre.

Results

A total of 408 patients were screened. Median arm volume excess was 239 ml (9.5%). One third of patients had little or no excess volume. Only 28.3% of patients had sufficient excess volume for trial eligibility. Of these, a significant number of patients were excluded because of active malignancy or previous decongestive therapy.

Conclusions

The finding of moderate to severe lymphedema observed in clinics screening for trial eligibility was less than expected. The natural history of lymphedema in breast cancer patients is potentially changing. Some patients may be presenting with sensory changes suggestive of lymphedema but due to other causes, such as nerve disruption following axillary dissection.
Appendix
Available only for authorised users
Literature
1.
go back to reference Maunsell E, Brisson J, Deschenes L (1993) Arm problems and psychological distress after surgery for breast cancer. Can J Surg 36:315–320PubMed Maunsell E, Brisson J, Deschenes L (1993) Arm problems and psychological distress after surgery for breast cancer. Can J Surg 36:315–320PubMed
2.
go back to reference Tobin MB, Lacey HJ, Meyer L et al (1993) The psychological morbidity of breast cancer-related arm swelling. Psychological morbidity of lymphoedema. Cancer 72:3248–3252PubMedCrossRef Tobin MB, Lacey HJ, Meyer L et al (1993) The psychological morbidity of breast cancer-related arm swelling. Psychological morbidity of lymphoedema. Cancer 72:3248–3252PubMedCrossRef
3.
go back to reference Petrek JA, Heelan MC (1998) Incidence of breast carcinoma-related lymphedema. Cancer 83(Suppl 12):2776–2781PubMedCrossRef Petrek JA, Heelan MC (1998) Incidence of breast carcinoma-related lymphedema. Cancer 83(Suppl 12):2776–2781PubMedCrossRef
4.
go back to reference Kwan W, Jackson J, Weir LM et al (2002) Chronic arm morbidity after curative breast cancer treatment: prevalence and impact on quality of life. J Clin Oncol 20:4242–4248PubMedCrossRef Kwan W, Jackson J, Weir LM et al (2002) Chronic arm morbidity after curative breast cancer treatment: prevalence and impact on quality of life. J Clin Oncol 20:4242–4248PubMedCrossRef
5.
go back to reference Larson D, Weinstein M, Goldberg I et al (1986) Edema of the arm as a function of the extent of axillary surgery in patients with stage I–II carcinoma of the breast treated with primary radiotherapy. Int J Radiat Oncol Biol Phys 12:1575–1582PubMed Larson D, Weinstein M, Goldberg I et al (1986) Edema of the arm as a function of the extent of axillary surgery in patients with stage I–II carcinoma of the breast treated with primary radiotherapy. Int J Radiat Oncol Biol Phys 12:1575–1582PubMed
6.
go back to reference Moffat FL Jr, Senofsky GM, Davis K et al (1992) Axillary node dissection for early breast cancer: some is good, but all is better. J Surg Oncol 51:8–13PubMedCrossRef Moffat FL Jr, Senofsky GM, Davis K et al (1992) Axillary node dissection for early breast cancer: some is good, but all is better. J Surg Oncol 51:8–13PubMedCrossRef
7.
go back to reference Ragaz J, Olivotto IA, Spinelli JJ et al (2005) Locoregional radiation therapy in patients with high-risk breast cancer receiving adjuvant chemotherapy: 20-year results of the British Columbia randomized trial. J Natl Cancer Inst 97(2):116–126PubMed Ragaz J, Olivotto IA, Spinelli JJ et al (2005) Locoregional radiation therapy in patients with high-risk breast cancer receiving adjuvant chemotherapy: 20-year results of the British Columbia randomized trial. J Natl Cancer Inst 97(2):116–126PubMed
8.
go back to reference Goffman TE, Laronga C, Wilson L et al (2004) Lymphedema of the arm and breast in irradiated breast cancer patients: risks in an era of dramatically changing axillary surgery. Breast J 10:405–411PubMedCrossRef Goffman TE, Laronga C, Wilson L et al (2004) Lymphedema of the arm and breast in irradiated breast cancer patients: risks in an era of dramatically changing axillary surgery. Breast J 10:405–411PubMedCrossRef
9.
go back to reference Erikson VS, Pearson ML, Ganz PA et al (2001) Arm Edema in Breast Cancer Patients. J Natl Cancer Inst 93:96–111CrossRef Erikson VS, Pearson ML, Ganz PA et al (2001) Arm Edema in Breast Cancer Patients. J Natl Cancer Inst 93:96–111CrossRef
10.
go back to reference Hayes S, Cornish B, Newman B (2005) Comparison of methods to diagnose lymphoedema among breast cancer survivors: 6-month follow-up. Breast Cancer Res Treat 89:221–226PubMedCrossRef Hayes S, Cornish B, Newman B (2005) Comparison of methods to diagnose lymphoedema among breast cancer survivors: 6-month follow-up. Breast Cancer Res Treat 89:221–226PubMedCrossRef
11.
go back to reference Kosir MA, Rymal C, Koppolu P et al (2001) Surgical outcomes after breast cancer surgery: measuring acute lymphedema. J Surg Res 95:147–151PubMedCrossRef Kosir MA, Rymal C, Koppolu P et al (2001) Surgical outcomes after breast cancer surgery: measuring acute lymphedema. J Surg Res 95:147–151PubMedCrossRef
12.
go back to reference Voogd AC, Ververs JM, Vingerhoets AJ et al (2003) Lymphoedema and reduced shoulder function as indicators of quality of life after axillary lymph node dissection for invasive breast cancer. Br J Surg 90:76–81PubMedCrossRef Voogd AC, Ververs JM, Vingerhoets AJ et al (2003) Lymphoedema and reduced shoulder function as indicators of quality of life after axillary lymph node dissection for invasive breast cancer. Br J Surg 90:76–81PubMedCrossRef
13.
go back to reference Badger CMA, Peacock JL, Mortimer PS (2002) A randomized, controlled, parallel-group clinical trial comparing multiplayer bandaging followed by hosiery versus hosiery alone in the treatment of patients with lymphedema of the limb. Cancer 88:2832–2837CrossRef Badger CMA, Peacock JL, Mortimer PS (2002) A randomized, controlled, parallel-group clinical trial comparing multiplayer bandaging followed by hosiery versus hosiery alone in the treatment of patients with lymphedema of the limb. Cancer 88:2832–2837CrossRef
14.
go back to reference Szuba A, Achalu R, Rockson SG (2002) Decongestive lymphatic therapy for patients with breast carcinoma-associated lymphedema. A randomized, prospective study of a role for adjunctive intermittent pneumatic compression. Cancer 95(11):2260–2267PubMedCrossRef Szuba A, Achalu R, Rockson SG (2002) Decongestive lymphatic therapy for patients with breast carcinoma-associated lymphedema. A randomized, prospective study of a role for adjunctive intermittent pneumatic compression. Cancer 95(11):2260–2267PubMedCrossRef
15.
go back to reference Carter BJ (1997) Women’s experiences of lymphedema. Oncol Nurs Forum 24:875–882PubMed Carter BJ (1997) Women’s experiences of lymphedema. Oncol Nurs Forum 24:875–882PubMed
16.
go back to reference Albert US, Koller M, Kopp I et al (2006) Early self-reported impairments in arm functioning of primary breast cancer patients predict late side effects of axillary lymph node dissection: results from a population-based cohort study. Breast Cancer Res Treat 100:285–292PubMedCrossRef Albert US, Koller M, Kopp I et al (2006) Early self-reported impairments in arm functioning of primary breast cancer patients predict late side effects of axillary lymph node dissection: results from a population-based cohort study. Breast Cancer Res Treat 100:285–292PubMedCrossRef
17.
go back to reference van Dongen JA, Voogd AC, Fentiman IS et al (2000) Long-term results of a randomized trial comparing breast-conserving therapy with mastectomy: European organization for research and treatment of cancer 10801 trial. J Natl Cancer Inst 92(14):1143–1150PubMedCrossRef van Dongen JA, Voogd AC, Fentiman IS et al (2000) Long-term results of a randomized trial comparing breast-conserving therapy with mastectomy: European organization for research and treatment of cancer 10801 trial. J Natl Cancer Inst 92(14):1143–1150PubMedCrossRef
18.
go back to reference Naik AM, Fey J, Gemignani M et al (2004) The risk of axillary relapse after sentinel lymph node biopsy for breast cancer is comparable with that of axillary lymph node dissection: a follow-up study of 4008 procedures. Ann Surg 240(3):462–468PubMedCrossRef Naik AM, Fey J, Gemignani M et al (2004) The risk of axillary relapse after sentinel lymph node biopsy for breast cancer is comparable with that of axillary lymph node dissection: a follow-up study of 4008 procedures. Ann Surg 240(3):462–468PubMedCrossRef
19.
go back to reference Pierce LJ, Moughan J, White J et al (2005) 1998–1999 patterns of care study process survey of national practice patterns using breast-conserving surgery and radiotherapy in the management of stage I–II breast cancer. Int J Radiat Oncol Biol Phys 62(1):183–192PubMedCrossRef Pierce LJ, Moughan J, White J et al (2005) 1998–1999 patterns of care study process survey of national practice patterns using breast-conserving surgery and radiotherapy in the management of stage I–II breast cancer. Int J Radiat Oncol Biol Phys 62(1):183–192PubMedCrossRef
20.
go back to reference Mansel RE, Fallowfield L, Kissin M et al (2006) Randomized multicenter trial of sentinel node biopsy versus standard axillary treatment in operable breast cancer: the ALMANAC Trial. J Natl Cancer Inst 98(9):599–609PubMedCrossRef Mansel RE, Fallowfield L, Kissin M et al (2006) Randomized multicenter trial of sentinel node biopsy versus standard axillary treatment in operable breast cancer: the ALMANAC Trial. J Natl Cancer Inst 98(9):599–609PubMedCrossRef
21.
go back to reference Dayes IS, Whelan TJ, Julian JA et al (2006) Cross-border referral for early breast cancer: an analysis of radiation fractionation patterns. Current Oncology 13:124–129PubMed Dayes IS, Whelan TJ, Julian JA et al (2006) Cross-border referral for early breast cancer: an analysis of radiation fractionation patterns. Current Oncology 13:124–129PubMed
22.
go back to reference Swedborg I, Norrefalk JR, Piller NB et al (1993) Lymphoedema post-mastectomy: is elevation alone an effective treatment? Scand J Rehabil Med 25:79–82PubMed Swedborg I, Norrefalk JR, Piller NB et al (1993) Lymphoedema post-mastectomy: is elevation alone an effective treatment? Scand J Rehabil Med 25:79–82PubMed
23.
go back to reference NCI Common Terminology Criteria for Adverse Events (version 3.). Published August 9, 2006. (http://ctep.cancer.gov/forms/CTCAEv3.pdf). Accessed February 6, 2007 NCI Common Terminology Criteria for Adverse Events (version 3.). Published August 9, 2006. (http://​ctep.​cancer.​gov/​forms/​CTCAEv3.​pdf). Accessed February 6, 2007
24.
go back to reference Haines TP, Sinnamon P (2007) Early arm swelling after breast surgery: changes on both sides. Breast Cancer Res Treat 101:105–112PubMedCrossRef Haines TP, Sinnamon P (2007) Early arm swelling after breast surgery: changes on both sides. Breast Cancer Res Treat 101:105–112PubMedCrossRef
25.
go back to reference Breast Cancer Support. (bcsupport.org). Accessed 25 January 2007 Breast Cancer Support. (bcsupport.org). Accessed 25 January 2007
26.
go back to reference The Breast Site. (www.thebreastsite.com). Accessed 25 January 2007 The Breast Site. (www.thebreastsite.com). Accessed 25 January 2007
27.
go back to reference The Cancer Information Network. (www.ontumor.com). Accessed 11 August 2005 The Cancer Information Network. (www.ontumor.com). Accessed 11 August 2005
28.
go back to reference Casley-Smith JR (1994) Measuring and representing peripheral oedema and its alterations. Lymphology 27:56–70PubMed Casley-Smith JR (1994) Measuring and representing peripheral oedema and its alterations. Lymphology 27:56–70PubMed
29.
go back to reference McNeely ML, Magee DJ, Lees AW et al (2004) The addition of manual lymph drainage to compression therapy for breast cancer related lymphedema: a randomized controlled trial. Breast Cancer Res Treat 86:95–106PubMedCrossRef McNeely ML, Magee DJ, Lees AW et al (2004) The addition of manual lymph drainage to compression therapy for breast cancer related lymphedema: a randomized controlled trial. Breast Cancer Res Treat 86:95–106PubMedCrossRef
Metadata
Title
Lymphedema in women with breast cancer: characteristics of patients screened for a randomized trial
Authors
Ian S. Dayes
Mark N. Levine
J. A. Julian
Kathleen I. Pritchard
David P. D’Souza
Lyn Kligman
Donnalue Reise
Jennifer A. Wiernikowski
L. Bonilla
T. J. Whelan
Publication date
01-07-2008
Publisher
Springer US
Published in
Breast Cancer Research and Treatment / Issue 2/2008
Print ISSN: 0167-6806
Electronic ISSN: 1573-7217
DOI
https://doi.org/10.1007/s10549-007-9727-0

Other articles of this Issue 2/2008

Breast Cancer Research and Treatment 2/2008 Go to the issue
Webinar | 19-02-2024 | 17:30 (CET)

Keynote webinar | Spotlight on antibody–drug conjugates in cancer

Antibody–drug conjugates (ADCs) are novel agents that have shown promise across multiple tumor types. Explore the current landscape of ADCs in breast and lung cancer with our experts, and gain insights into the mechanism of action, key clinical trials data, existing challenges, and future directions.

Dr. Véronique Diéras
Prof. Fabrice Barlesi
Developed by: Springer Medicine