Letter to the Editor: Comment on Kuruvilla AS, et al. Risk Factors Associated With Postmastectomy Breast Cancer Lymphedema: Amulticenter Retrospective Analysis. (Ann Plast Surg. 2022;88(3 suppl 3):S239–S245)

Abstract

To the Editor:I read with great interest the article by Kuruvilla et al, 1 in which they evaluated the risk factors predictive of lymphedema-related events within 2 years of mastectomy in breast cancer patients. The predictive risk factors included higher Elixhauser score, prolonged hospitalization for mastectomy, more recent mastectomy procedure, obesity, younger age, non-Asian race, Medicaid insurance, and hypertension (all P < 0.01). Detailed information about chemotherapy schedules was not described in this article. The association of taxanes with the development of peripheral edema was evaluated previously. Taxanes may cause systemic disruption, which could have a longer-term effect on lymphatic function leading to lymphedema in breast cancer patients. Cariati and colleagues 2 in their hypothesis-generating study investigated risk factors for lymphedema with a specific focus on the potential impact of chemotherapy. They found that patients who received adjuvant taxanes were nearly 3 times more likely to develop lymphedema than patients who did not. Therefore, adjuvant taxane use might be one of the predictive factors for postmastectomy breast cancer lymphedema.