Who Will Continuously Depend on Compression to Control Persistent or Progressive Breast Cancer-Related Lymphedema Despite 2 Years of Conservative Care?

Abstract

Background: When a patient with breast cancer-related lymphedema (BCRL) depends on continuous compression management, that is, when interstitial fluid accumulation is continuously ongoing, surgical treatment should be considered. Physiologic surgery is considered more effective for early-stage lymphedema. The purpose of this study was to identify predictors of patients with BCRL who will be compression-dependent despite 2 years of conservative care. Methods: This study included patients with BCRL who followed up for 2 years. Patients were classified into two groups (compression-dependent vs. compression-free). We identified the proportion of compression-dependent patients and predictors of compression dependence. Results: Among 208 patients, 125 (60.1%) were classified into the compression-dependent group. Compression dependence was higher in patients with direct radiotherapy to the lymph nodes (LNs), those with five or more LNs resections, and those with BCRL occurring at least 1 year after surgery. Conclusions: BCRL patients with direct radiotherapy to the LNs, extensive LN dissection, and delayed onset may be compression-dependent despite 2 years of conservative care. Initially moderate to severe BCRL and a history of cellulitis also seem to be strongly associated with compression dependence. Our results allow for the early prediction of compression-dependent patients who should be considered for physiologic surgery.

Comparison of machine learning models for predicting the risk of breast cancer-related lymphedema in Chinese women

“…Early prediction and detection of cancer-related symptoms such as BCRL are essential for improving the health outcomes of cancer patients. 14 , 15 , 16 Traditional statistical methods, such as multiple linear regression tests, have been used to identify predictors of health-related outcomes, but those statistical methods require a clear hypothesis and a rigorous research design, and their calculations of parameters can be modified only by redesigning the respective studies. 17 In recent years, many advanced technologies, such as machine learning (ML), have emerged as valuable approaches for expressing parameters in cancer treatments and outcomes.…”

Comparative analysis between Side-to-end and End-to-end LVA for secondary lower limb lymphedema

“…Patients that were deemed nonresponsive to therapy were referred for surgery. 22 The mean body mass index was 26.7 ± 4.1 kg/m 2 in the end-to-end group and 25.9 ± 3.5 kg/m 2 in the side-to-end group ( p = 0.426). The International Society of Lymphology staging for the end-to-end group was composed of 3.2 percent stage I, 23.8 percent stage II early, 61.9 percent stage II late, and 11.1 percent stage III patients.…”

Crosstalk Between microRNAs and the Pathological Features of Secondary Lymphedema

“…Prolonged blockage of lymphatic flow and the accumulation of lymph lead to the pathological features of lymphedema, including inflammation, immune dysfunction, tissue remodeling, fibrosis, and aberrant lipid metabolism. To date, there is no molecular-based therapy for secondary lymphedema and the condition is usually treated with massage, manual lymphatic drainage, compression bandages, remedial exercise, and dietary intervention programs ( Do et al, 2017 ; Jung et al, 2020 ). Although, the damage to lymphatic vessels may be treated through pharmaceutical therapies, stimulating lymphangiogenesis; clinical trials to evaluate growth factor therapy have yet to be conducted ( Forte et al, 2019 ).…”