Abstract
Objectives:Breast cancer related lymphedema (BCRL) is a common complication of current breast cancer treatment modalities, significantly lowering quality of life for these patients and often leading to recurrent infections. Here, based on pre-clinical literature, we aim to retrospectively evaluate the risks of prescribed medications on BCRL development.Methods:All post-operative breast cancer patients who received radiotherapy from 2005–2013 at Massachusetts General Hospital and developed lymphedema(n=115) were included in the analysis. Comparable patients without lymphedema(n=230) were randomly selected as control. The following classes of medications were analyzed: NSAIDs, corticosteroids, angiotensin system inhibitors, calcium channel blockers and hormonal therapy. Known risk factors for lymphedema development were included as variables, including BMI, age at diagnosis, type of surgery, number of lymph nodes removed and radiation therapy. Outcomes were BCRL development and lymphedema severity.Results:Similarly, to previous studies, we found that an increase in BMI increases the risk of BCRL(p=0.006) and axillary lymph node dissection has a higher risk of developing BCRL compared to sentinel lymph node biopsy(p=0.045). None of the drugs studied increased the risk of BCRL development or lymphedema severity. However, lymphedema severity was positively correlated with the number of lymph nodes removed(p=0.034).Conclusion:We found that anti-inflammatory drugs, anti-hypertensive drugs and hormonal therapy taken during the year postoperatively do not increase the risk of BCRL development or lymphedema severity in breast cancer patients. While others have demonstrated that the number of lymph nodes removed during surgery increases the risk of BCRL, we found it also correlates to lymphedema severity.
Highlights
Over a million women are diagnosed annually with breast cancer worldwide, accounting for approximately a quarter of all diagnosed cancers in women [1,2]
Data retrieved from the medical records were breast cancer related lymphedema (BCRL) development, severity of lymphedema measured by relative volume change (RVC), and known risk factors for BCRL development: body mass index (BMI), type of surgery, number of lymph nodes removed and radiation therapy (Table 1)
While univariate analysis showed that several risk factors were statistically related to the frequency of BCRL, only BMI and the axillary surgery were found statistically significant in the multivariable analysis
Summary
Over a million women are diagnosed annually with breast cancer worldwide, accounting for approximately a quarter of all diagnosed cancers in women [1,2] These women subsequently undergo treatment that can entail a combination of surgical intervention, radiation therapy, chemotherapy, hormonal therapy and/or targeted therapy. The five year survival rate for stages of breast cancer from carcinoma in situ thru invasive cancer, is around 90% [1] For these patients, lymphedema of the upper extremity is one of the most well-known long-term complications of surgical intervention, including axillary lymph node dissection (ALND) and/or sentinel lymph node biopsy (SLNB) [3]. It is estimated that there are 10 million patients in the United States currently afflicted with lymphedema [6,7,8] Of these it is estimated that over seven million meet the criteria for BCRL.
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
