Supraclavicular Irradiation Induces Lymphedema in Breast Cancer Patients Treated with Axillary Lymph Node Dissection and Taxane-Containing Chemotherapy

Purpose. Breast cancer-related lymphedema (LE) significantly impairs the patients’ quality of life. Axillary lymph node dissection (ALND) is a strong risk factor for LE in breast cancer surgery. In addition, postoperative administration of docetaxel (DTX) has been reported to be a risk factor for LE...

Full description

Saved in:
Bibliographic Details
Main Authors: Nanae Horisawa, Akiyo Yoshimura, Isao Oze, Masataka Sawaki, Masaya Hattori, Haruru Kotani, Ayumi Kataoka, Yuri Ozaki, Kazuki Nozawa, Yuka Endo, Daiki Takatsuka, Ayaka Isogai, Hiroji Iwata
Format: Article
Language:English
Published: Wiley 2024-01-01
Series:The Breast Journal
Online Access:http://dx.doi.org/10.1155/2024/3250143
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1849685477499600896
author Nanae Horisawa
Akiyo Yoshimura
Isao Oze
Masataka Sawaki
Masaya Hattori
Haruru Kotani
Ayumi Kataoka
Yuri Ozaki
Kazuki Nozawa
Yuka Endo
Daiki Takatsuka
Ayaka Isogai
Hiroji Iwata
author_facet Nanae Horisawa
Akiyo Yoshimura
Isao Oze
Masataka Sawaki
Masaya Hattori
Haruru Kotani
Ayumi Kataoka
Yuri Ozaki
Kazuki Nozawa
Yuka Endo
Daiki Takatsuka
Ayaka Isogai
Hiroji Iwata
author_sort Nanae Horisawa
collection DOAJ
description Purpose. Breast cancer-related lymphedema (LE) significantly impairs the patients’ quality of life. Axillary lymph node dissection (ALND) is a strong risk factor for LE in breast cancer surgery. In addition, postoperative administration of docetaxel (DTX) has been reported to be a risk factor for LE in patients who undergo ALND. Herein, we performed the risk of objective LE after ALND. Methods. Patients who visited the medical follow-up clinic between 12 November 2018 and 11 January 2019 and at least one year postoperatively were eligible for this study. The risk factors for objective LE according to taxane-containing regimen, radiation therapy, and body mass index and the effects of a taxane-containing regimen followed by supraclavicular irradiation on LE were examined. Results. A total of 214 patients were included in this analysis, and objective LE was observed in 52 patients (24%). Univariate and multivariate analyses showed that only supraclavicular field irradiation was a statistically significant risk factor for objective LE. In addition, the sequential use of taxane-containing regimens and supraclavicular RT was shown to be a more likely risk factor for LE than ALND alone. We also compared each taxane regimen with supraclavicular RT and found that DTX was more likely to be a risk factor for LE in cases of sequential use of supraclavicular RT than with ALND alone. However, when comparing DTX with supraclavicular RT and PTX with supraclavicular RT directly, there was no statistically significant difference in the risk of objective LE between the two groups. Conclusion. The risk for LE was more likely to be higher with the sequential use of taxane-containing chemotherapy and supraclavicular field irradiation. Therefore, management of LE is important in these cases.
format Article
id doaj-art-bf1a29536cb0425983c65612bab2bcb4
institution DOAJ
issn 1524-4741
language English
publishDate 2024-01-01
publisher Wiley
record_format Article
series The Breast Journal
spelling doaj-art-bf1a29536cb0425983c65612bab2bcb42025-08-20T03:23:07ZengWileyThe Breast Journal1524-47412024-01-01202410.1155/2024/3250143Supraclavicular Irradiation Induces Lymphedema in Breast Cancer Patients Treated with Axillary Lymph Node Dissection and Taxane-Containing ChemotherapyNanae Horisawa0Akiyo Yoshimura1Isao Oze2Masataka Sawaki3Masaya Hattori4Haruru Kotani5Ayumi Kataoka6Yuri Ozaki7Kazuki Nozawa8Yuka Endo9Daiki Takatsuka10Ayaka Isogai11Hiroji Iwata12Department of Breast OncologyDepartment of Breast OncologyDivision of Cancer Epidemiology and PreventionDepartment of Breast OncologyDepartment of Breast OncologyDepartment of Breast OncologyDepartment of Breast OncologyDepartment of Breast OncologyDepartment of Breast OncologyDepartment of Breast OncologyDepartment of Breast OncologyDepartment of Breast OncologyDepartment of Breast OncologyPurpose. Breast cancer-related lymphedema (LE) significantly impairs the patients’ quality of life. Axillary lymph node dissection (ALND) is a strong risk factor for LE in breast cancer surgery. In addition, postoperative administration of docetaxel (DTX) has been reported to be a risk factor for LE in patients who undergo ALND. Herein, we performed the risk of objective LE after ALND. Methods. Patients who visited the medical follow-up clinic between 12 November 2018 and 11 January 2019 and at least one year postoperatively were eligible for this study. The risk factors for objective LE according to taxane-containing regimen, radiation therapy, and body mass index and the effects of a taxane-containing regimen followed by supraclavicular irradiation on LE were examined. Results. A total of 214 patients were included in this analysis, and objective LE was observed in 52 patients (24%). Univariate and multivariate analyses showed that only supraclavicular field irradiation was a statistically significant risk factor for objective LE. In addition, the sequential use of taxane-containing regimens and supraclavicular RT was shown to be a more likely risk factor for LE than ALND alone. We also compared each taxane regimen with supraclavicular RT and found that DTX was more likely to be a risk factor for LE in cases of sequential use of supraclavicular RT than with ALND alone. However, when comparing DTX with supraclavicular RT and PTX with supraclavicular RT directly, there was no statistically significant difference in the risk of objective LE between the two groups. Conclusion. The risk for LE was more likely to be higher with the sequential use of taxane-containing chemotherapy and supraclavicular field irradiation. Therefore, management of LE is important in these cases.http://dx.doi.org/10.1155/2024/3250143
spellingShingle Nanae Horisawa
Akiyo Yoshimura
Isao Oze
Masataka Sawaki
Masaya Hattori
Haruru Kotani
Ayumi Kataoka
Yuri Ozaki
Kazuki Nozawa
Yuka Endo
Daiki Takatsuka
Ayaka Isogai
Hiroji Iwata
Supraclavicular Irradiation Induces Lymphedema in Breast Cancer Patients Treated with Axillary Lymph Node Dissection and Taxane-Containing Chemotherapy
The Breast Journal
title Supraclavicular Irradiation Induces Lymphedema in Breast Cancer Patients Treated with Axillary Lymph Node Dissection and Taxane-Containing Chemotherapy
title_full Supraclavicular Irradiation Induces Lymphedema in Breast Cancer Patients Treated with Axillary Lymph Node Dissection and Taxane-Containing Chemotherapy
title_fullStr Supraclavicular Irradiation Induces Lymphedema in Breast Cancer Patients Treated with Axillary Lymph Node Dissection and Taxane-Containing Chemotherapy
title_full_unstemmed Supraclavicular Irradiation Induces Lymphedema in Breast Cancer Patients Treated with Axillary Lymph Node Dissection and Taxane-Containing Chemotherapy
title_short Supraclavicular Irradiation Induces Lymphedema in Breast Cancer Patients Treated with Axillary Lymph Node Dissection and Taxane-Containing Chemotherapy
title_sort supraclavicular irradiation induces lymphedema in breast cancer patients treated with axillary lymph node dissection and taxane containing chemotherapy
url http://dx.doi.org/10.1155/2024/3250143
work_keys_str_mv AT nanaehorisawa supraclavicularirradiationinduceslymphedemainbreastcancerpatientstreatedwithaxillarylymphnodedissectionandtaxanecontainingchemotherapy
AT akiyoyoshimura supraclavicularirradiationinduceslymphedemainbreastcancerpatientstreatedwithaxillarylymphnodedissectionandtaxanecontainingchemotherapy
AT isaooze supraclavicularirradiationinduceslymphedemainbreastcancerpatientstreatedwithaxillarylymphnodedissectionandtaxanecontainingchemotherapy
AT masatakasawaki supraclavicularirradiationinduceslymphedemainbreastcancerpatientstreatedwithaxillarylymphnodedissectionandtaxanecontainingchemotherapy
AT masayahattori supraclavicularirradiationinduceslymphedemainbreastcancerpatientstreatedwithaxillarylymphnodedissectionandtaxanecontainingchemotherapy
AT harurukotani supraclavicularirradiationinduceslymphedemainbreastcancerpatientstreatedwithaxillarylymphnodedissectionandtaxanecontainingchemotherapy
AT ayumikataoka supraclavicularirradiationinduceslymphedemainbreastcancerpatientstreatedwithaxillarylymphnodedissectionandtaxanecontainingchemotherapy
AT yuriozaki supraclavicularirradiationinduceslymphedemainbreastcancerpatientstreatedwithaxillarylymphnodedissectionandtaxanecontainingchemotherapy
AT kazukinozawa supraclavicularirradiationinduceslymphedemainbreastcancerpatientstreatedwithaxillarylymphnodedissectionandtaxanecontainingchemotherapy
AT yukaendo supraclavicularirradiationinduceslymphedemainbreastcancerpatientstreatedwithaxillarylymphnodedissectionandtaxanecontainingchemotherapy
AT daikitakatsuka supraclavicularirradiationinduceslymphedemainbreastcancerpatientstreatedwithaxillarylymphnodedissectionandtaxanecontainingchemotherapy
AT ayakaisogai supraclavicularirradiationinduceslymphedemainbreastcancerpatientstreatedwithaxillarylymphnodedissectionandtaxanecontainingchemotherapy
AT hirojiiwata supraclavicularirradiationinduceslymphedemainbreastcancerpatientstreatedwithaxillarylymphnodedissectionandtaxanecontainingchemotherapy