Black women are at higher risk for lymphedema after breast cancer surgery

TUESDAY December 7, 2021 (HealthDay News) – A condition called lymphedema is a well-known side effect of breast cancer treatment which can lead to swelling of the arms and legs.

New research suggests that black women are more than three times the risk of this painful problem compared to white women.

“Lymphedema worsens the quality of life of breast cancer patients, ”said study lead author Dr Andrea Barrio. She is an associate attending physician in the Breast after-sales service at Memorial Sloan Kettering Cancer Center in New York.

Understand the links between the breed, cancer treatment and the effects of treatment could ultimately help improve the quality of life for breast cancer patients and survivors, Barrio said in a press release from the San Antonio Breast Cancer Symposium.

Lymphedema has been somewhat overlooked in the research arena, said Dr. Stephanie Bernik, associate professor of breast surgery at the Icahn School of Medicine at Mount Sinai in New York City. She did not participate in the study.

“This study hints at some of the possible reasons for the racial disparity, as women with lymphedema were more likely to experience radiotherapy and chemotherapy before surgery, ”said Bernik.

“Black women with lymphedema were also more likely to have a higher BMI [body mass index], a known risk factor for developing lymphedema. There may very well be a genetic component, but more studies need to be done into the root causes of the problem, “she added.

For the study, researchers recruited more than 300 breast cancer patients and used measurements of arm volume rather than self-reported experiences or more common diagnostic codes.

The patients had undergone axillary lymph node dissection – surgical removal of lymph nodes – between November 2016 and March 2020.

The researchers measured the volume of the patients’ arms at baseline, after their surgery, and at six-month intervals. The study defined lymphedema as a relative volume change of 10% or more from baseline.

At 24 months of follow-up, approximately 25% of the women had developed lymphedema. Black women had a 3.5 times higher risk of lymphedema than white women, according to the results.

Hispanic women also had a higher risk of lymphedema than white women, with a three-fold higher risk. The study authors noted that the Hispanic population in the study was small (just 6%), so more study would be needed to confirm these results.

The type of treatment seemed to make a difference. The study found that women who received neoadjuvant chemotherapy – chemo before surgery – followed by lymph node removal were twice as likely to develop lymphedema as their counterparts who had initial surgery followed by dissection. axillary lymph nodes.

Barrio said other research has proven that black women are often diagnosed with advanced breast cancer. They are therefore more likely to need axillary surgery which may increase the risk of lymphedema. Yet the black race was the best predictor of the development of lymphedema.

Other factors associated with a higher risk of lymphedema were advanced age and longer time since surgery.

The results will be presented this week at the Breast Cancer Symposium. Results presented at medical meetings should be considered preliminary until published in a peer-reviewed journal.

More information

The National Cancer Institute in the United States has more information on lymphedema.

SOURCES: Stephanie Bernik, MD, chief, breast surgery, Mount Sinai West and associate professor, breast surgery, Icahn School of Medicine in Mount Sinai, New York City; San Antonio Breast Cancer Symposium, press release, December 7, 2021