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Breast Cancer Research and Treatment

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Open Access 01-11-2016 | Clinical trial

Use of a prospective surveillance model to prevent breast cancer treatment-related lymphedema: a single-center experience

Authors: Eun Joo Yang, Soyeon Ahn, Eun-Kyu Kim, Eunyoung Kang, Youngmi Park, Jae-Young Lim, Sung-Won Kim

Published in: Breast Cancer Research and Treatment | Issue 2/2016

Abstract

Purpose

Breast cancer patients undergoing axillary lymph node dissection (ALND) are at risk of lymphedema (LE). Successful management of LE relies on early diagnosis using sensitive modalities. In the current study, we explored the effectiveness of a surveillance program for lymphedema management (SLYM) compared to standard care.

Methods

Breast cancer patients who underwent ALND in Seoul National University Bundang Hospital from January 2008 to December 2015 were included in this prospective study. The SLYM commenced in May 2011. The LE outcomes of patients treated prior to initiation of the SLYM were compared with those of patients after SLYM implementation.

Results

A total of 707 patients were included, 390 in the SLYM group and 317 in the historical control (HC) group. A total of 203 patients (28.7 %) had episodes of all-stage LE during follow-up. Of these, 126 (19.7 %) were in the surveillance group and 77 (24.3 %) in the HC group. The overall 5-year cumulative incidence of LE (greater than stage 3) was 25 (95 % CI 15.4–34.6) (6.4 %) in the SLYM group and 48 (95 % CI, 15.4–34.6) (15.1 %) in the HC group. In the SLYM group, poor compliance had a significant impact on LE incidence (OR = 2.98, P = 0.002). Low level of self-monitoring and insight scores were significantly related to LE incidence (OR = 1.31, P = 0.025) after adjusting for age, body mass index, the type of surgery chosen, radiation therapy, and chemotherapy. With a cut-off of 29.5 days from operation to the first visit to the LE clinic, the sensitivity was 60 % and the specificity 61 % in terms of predicting a LE event.

Conclusions

Surveillance improves LE prevention compared to clinical evaluation. The first visit to the LE clinic should be made within 1 month after surgery. In the first year, visits should be made at intervals of less than 3 months.

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Title: Use of a prospective surveillance model to prevent breast cancer treatment-related lymphedema: a single-center experience
Authors: Eun Joo Yang
Soyeon Ahn
Eun-Kyu Kim
Eunyoung Kang
Youngmi Park
Jae-Young Lim
Sung-Won Kim
Publication date: 01-11-2016
Publisher: Springer US
Published in: Breast Cancer Research and Treatment / Issue 2/2016
Print ISSN: 0167-6806
Electronic ISSN: 1573-7217
DOI: https://doi.org/10.1007/s10549-016-3993-7

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