Abstract P2-14-15: Breast cancer-related lymphedema: Morbidity of sentinel node biopsy

Abstract

Abstract Purpose: Sentinel lymph node biopsy (SLNB) lowers morbidity of lymphedema then axillary lymph node dissection (ALND). However, there has been concern about incidence of lymphedema after SLNB especially when the number of harvested nodes during sentinel node biopsy procedure is more than a few. In this study, we assessed lymphedema incidence and its risk factors including the number excised lymph nodes in patients who underwent SLNB. Methods: Between January, 2011 and April, 2012, the records of 910 consecutive patients who underwent breast surgery with axillary staging (SLNB/ALND) for breast cancer at Seoul National University Hospital were reviewed. Lymphedema was assessed by circumferential upper extremity measurements. The lymphedema was defined as > 1cm for either the upper arm or the forearm. Patients with clinical records of the treatment for lymphedema in the rehabilitation clinic were regarded as having lymphedema. Univariate and multivariate analyses were performed to identify potential risk factors associated with lymphedema. Association of number of excised lymph nodes with lymphedema was analyzed by Spearman rank correlation coefficient. Results: At median follow-up of 69.8 months, 231 patients (25.4%) presented with lymphedema. In univariate analysis, body mass index (BMI) (P<0.001), T stage (P<0.001), N stage (P<0.001), type of surgery (P<0.001), ALND (P<0.001), neoadjuvant chemotherapy (P<0.001) and adjuvant chemotherapy (P=0.027) were significantly associated with lymphedema. In multivariate analysis BMI (P<0.001), ALND (P<0.001), neoadjuvant chemotherapy (P=0.044), and radiation therapy (P=0.046) were significantly associated with lymphedema. In patients treated with SLNB only (n=595), the incidence of lymphedema was 16.3% (n=97). In SLNB only subgroup, BMI was only significant risk factor of lymphedema. There was no correlation between number of excised lymph nodes during sentinel lymph node biopsy procedure with incidence of lymphedema (P=0.138). Conclusion: The risk of lymphedema is multifactorial in breast cancer surgery and adjuvant treatments. In SLNB alone patients, higher BMI was only significant factor correlated with lymphedema. Excised number of lymph nodes during sentinel biopsy procedure was not associated with lymphedema. Citation Format: Ju YW, Jung JG, Kim KE, Kim Y, Lee E, Lee H-B, Moon H-G, Han W, Noh D-Y. Breast cancer-related lymphedema: Morbidity of sentinel node biopsy [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr P2-14-15.