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Lymphovascular invasion and extranodal tumour extension are risk indicators of breast cancer related lymphoedema: an observational retrospective study with long-term follow-up.
- Source :
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BMC cancer [BMC Cancer] 2018 Sep 29; Vol. 18 (1), pp. 935. Date of Electronic Publication: 2018 Sep 29. - Publication Year :
- 2018
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Abstract
- Background: Breast cancer related lymphoedema (BCRL) occurs in a substantial proportion of breast cancer survivors and is a major contributor to patients' disability. Regrettably, there are no validated predictive biomarkers, diagnostic tools, and strong evidence-supported therapeutic strategies for BCRL. Here, we provide an integrative characterization of a large series of women with node-positive breast cancers and identify new bona fide predictors of BCRL occurrence.<br />Methods: Three hundred thirty-two cases of surgically-treated node-positive breast cancers were retrospectively collected (2-10.2 years of follow-up). Among them, 62 patients developed BCRL. To identify demographic and clinicopathologic features related to BCRL, Fisher's exact test or Chi-squared test were carried out for categorical variables; the Wilcoxon rank-sum was employed for continuous variables. Factors associated with BCRL occurrence were assessed using a Cox proportional hazards regression model.<br />Results: En-bloc dissection of the axillary lymph nodes but not the type of breast surgery impacted on BCRL development. Most of BCRL patients had a Luminal A-like neoplasm. The median number of lymph nodes involved by metastatic deposits was significantly higher in BCRL compared to the control group (pā=ā0.04). Both peritumoral lymphovascular invasion (LVI) and extranodal extension (ENE) of the metastasis had a negative impact on BCRL-free survival (pā=ā0.01). Specifically, patients with LVI and left side localization harboured 4-fold higher risk of developing BCRL, while right axillary nodes metastases with ENE increased the probability of BCRL compared to ENE-negative patients.<br />Conclusions: Assessment of LVI and ENE should be integrated with clinical and surgical data to improve BCRL risk stratification.
- Subjects :
- Adult
Aged
Aged, 80 and over
Axilla pathology
Axilla surgery
Breast Cancer Lymphedema mortality
Breast Cancer Lymphedema surgery
Disease-Free Survival
Female
Follow-Up Studies
Humans
Lymph Node Excision
Lymph Nodes pathology
Lymph Nodes surgery
Middle Aged
Neoplasm Invasiveness
Retrospective Studies
Breast Cancer Lymphedema epidemiology
Breast Cancer Lymphedema pathology
Subjects
Details
- Language :
- English
- ISSN :
- 1471-2407
- Volume :
- 18
- Issue :
- 1
- Database :
- MEDLINE
- Journal :
- BMC cancer
- Publication Type :
- Academic Journal
- Accession number :
- 30268112
- Full Text :
- https://doi.org/10.1186/s12885-018-4851-2