Factors influencing response to lymphedema treatment in patients with breast cancer-related lymphedema

Eyigör, Sibel; Çınar, Ece; Caramat, İsmail; Ünlü, Burcu

doi:10.1007/s00520-015-2633-9

Cited by 18 publications

(12 citation statements)

References 15 publications

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“…Current study showed that surgical method, radiotherapy, and the number of removed lymph nodes were not associated with CDT efficacy, which was confirmed by Liao et al . While Eyigor et al found similar results to our study; they also added that tamoxifen use was positively correlated with PEV . In contrast, hormonotherapy was not a predictor in the current study.…”

Section: Discussionsupporting

confidence: 90%

“…Due to the decrease of lymphatic capacity with age, lymphedema risk might be greater in older patients . However, the relationship with age and the occurrence of lymphedema or efficacy of CDT are still controversial . In this study, age was not found as a predictive factor for lymphedema severity or CDT efficacy.…”

Section: Discussioncontrasting

confidence: 58%

“…The median lymphedematous limb volume reduced from 3449 to 3173 mL with 15 sessions of CDT, which shows that patients were successfully treated, statistically. PEV was used instead of excess volume for determining lymphedema severity, as in previous studies . The median PEV before CDT was 22.6%.…”

Section: Discussionmentioning

confidence: 99%

“…Numerous studies reported that CDT was an effective treatment method for BCRL . In contrast, there are few studies about the predictive factors for the effectiveness of treatment . Predicting the response to CDT and identifying factors that affect the efficacy of treatment could provide physicians a better clinical perspective on the management of BCRL treatment.…”

Section: Introductionmentioning

confidence: 99%

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The results of the intensive phase of complete decongestive therapy and the determination of predictive factors for response to treatment in patients with breast cancer related‐lymphedema

et al. 2020

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Background: Lymphedema is a common complication of breast cancer or its treatment. The gold standard treatment for lymphedema is complete decongestive therapy. There are few studies about the predictive factors for the effectiveness of complete decongestive therapy.Aim: To evaluate the results of the intensive phase of complete decongestive therapy, and to determine the predictive factors for the response to treatment in patients with breast cancer-related lymphedema.Methods and Results: Fifty-seven patients with breast cancer-related lymphedema (mean age: 56.2 ± 11.2 years) who underwent complete decongestive therapy between 2014 and 2016 were evaluated retrospectively. Extremity volume was calculated using circumferential measurements and the truncated cone formula technique. Response to treatment was evaluated using the percentage reduction of excess volume formula, which was obtained by calculating the extremity volume before and after treatment. The median percentage reduction of excess volume was 27.7% (IQR,13.6-50.3). The history of skin infection was related to lower percentage reduction of excess volume (P = 0.001). Although percentage reduction of excess volume was positively correlated with education level (r = 0.286, P = 0.031), percentage reduction of excess volume was negatively correlated with lymphedema duration (r = −0.361, P = 0.006), postoperative duration (r = −0.314, P = 0.018), percentage of excess volume (r = −0.398, P = 0.002), and number of complete decongestive therapy sessions (r = −0.436, P = 0.001). Univariate and multivariate analyses showed that the independent variables for percentage reduction of excess volume were percentage of excess volume (P = 0.009) and education level (P = 0.021). Conclusion:Complete decongestive therapy is an effective method in patients with breast cancer related-lymphedema. The most important predictive factors for the efficacy of treatment were found as percentage of excess volume and education level. Patients with breast cancer should be followed up regularly and receive complete decongestive therapy in the early stage of lymphedema.Abbreviations: ALND, axillary lymph node dissection; BMI, body mass index; CDT, complete decongestive therapy; IQR, interquartile range; PEV, percentage of excess volume; PREV, percentage reduction of excess volume; SD, standard deviation; SLNB, sentinel lymph node biopsy. 4 of 8 KESKIN ET AL. 4 of 8 KESKIN ET AL. How to cite this article: Keskin D, Dalyan M, Ünsal-Delialio glu S, Düzlü-Öztürk Ü. The results of the intensive phase of complete decongestive therapy and the determination of predictive factors for response to treatment in patients with breast cancer related-lymphedema. Cancer Reports. 2020;e1225. https://doi.org/10.1002/cnr2.1225 8 of 8 KESKIN ET AL. How to cite this article: Keskin D, Dalyan M, Ünsal-Delialio glu S, Düzlü-Öztürk Ü. The results of the intensive phase of complete decongestive therapy and the determination of predictive factors for response to treatment in patients with breast cancer related-lymph...

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Section: Discussionsupporting

confidence: 90%

Section: Discussioncontrasting

confidence: 58%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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The results of the intensive phase of complete decongestive therapy and the determination of predictive factors for response to treatment in patients with breast cancer related‐lymphedema

et al. 2020

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“…In one study [12], this approach was found to be cost effective during the first year of surveillance. However, a large amount of inter-individual variability exists in patient outcomes associated with LE preventive or treatment strategies [15,16]. Understanding distinct patterns of limb volume change after breast cancer treatment may provide insights into the natural behavior of these changes, and assist with identification of a subset of women at higher risk for the development of LE who can then be targeted for increased surveillance.…”

Section: Introductionmentioning

confidence: 99%

Differences in limb volume trajectories after breast cancer treatment

et al. 2015

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Purpose ~20% of patients develop lymphedema (LE) following breast cancer (BC) surgery. An evaluation of distinct trajectories of volume change may improve our ability to diagnose LE sooner. The purposes of this study were to identify subgroups of women with distinct trajectories of limb volume changes following BC surgery and to evaluate for phenotypic differences among these classes. Methods In this prospective longitudinal study, 380 women were enrolled prior to unilateral BC surgery. Upper limb bioimpedance was measured preoperatively and serially for one year postoperatively. Resistance ratios (RR) were calculated. A RR of >1 indicates affected limb volume > unaffected limb volume. Latent class growth analysis (LCGA) was used to identify classes of women with distinct postoperative RR trajectories. Differences among classes were evaluated using analyses of variance and Chi square analyses. Results Three distinct classes were identified: RR <0.95 (37.9%), RR ~1.00 (46.8%), RR >1.05 (15.3%). Patients in the RR >1.05 class were more likely to have diabetes (p=0.036); were more likely to have BC on their dominant side (P<0.001); had higher RR ratios at the preoperative and one-month assessments (P<0.001); and were more likely to be diagnosed with LE (p<0.001). Conclusions LCGA is a useful analytic technique to identify subgroups of women who may be at higher risk for the development of LE, based on trajectories of limb volume change after BC surgery. Implications for cancer survivors Assessment of preoperative and one-month bioimpedance RRs may allow for the earlier identification of patients who are at higher risk for the development of LE.

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Breast Cancer-Related Lymphedema and Shoulder Impairments: Physical Therapy and Plastic Surgery

Kloer

Massa

Atia

et al. 2021

Common Issues in Breast Cancer Survivors

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Factors influencing response to lymphedema treatment in patients with breast cancer-related lymphedema

Cited by 18 publications

References 15 publications

The results of the intensive phase of complete decongestive therapy and the determination of predictive factors for response to treatment in patients with breast cancer related‐lymphedema

The results of the intensive phase of complete decongestive therapy and the determination of predictive factors for response to treatment in patients with breast cancer related‐lymphedema

Differences in limb volume trajectories after breast cancer treatment

Breast Cancer-Related Lymphedema and Shoulder Impairments: Physical Therapy and Plastic Surgery

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