Black women at higher risk of lymphedema after breast cancer surgery


Written by Cara Murez
HealthDay Reporter

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

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

“Lymphedema worsens the quality of life for breast cancer patients, “said the study ‘s lead author, Dr Andrea Barrio chest service department at the Memorial Sloan Kettering Cancer Center in New York City.

Understanding the connections between races, cancer treatment and the effects of the treatment could ultimately help improve the quality of life of breast cancer patients and survivors, Barrio said in a statement from a symposium on breast cancer in San Antonio.

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

“This study suggests some of the possible causes of racial inequality, as women with lymphedema were more likely to undergo radiation therapy and chemotherapy before the operation, ”Bernik said.

“Black women with lymphedema also had a higher BMI [body mass index], a known risk factor for the development of lymphedema. There may well be a genetic component, but more studies are needed to focus on the root causes of the problem, ”she added.

In the study, the researchers included more than 300 breast cancer patients and used hand volume measurements instead of common experiences or diagnostic codes.

Patients underwent axillary lymph node dissection – surgical removal lymph nodes – between November 2016 and March 2020

The researchers measured the volume of the patients’ hands at the beginning, after the operation and at intervals of six months. The study defined lymphedema as a relative volume change of 10% or more of baseline.

After 24 months of follow-up, about 25% of women had lymphedema. Black women had a 3.5-fold higher risk of lymphedema than white women, the findings showed.

Hispanics were also more likely to have lymphedema than white women, with a threefold increased risk. The authors of the study noted that the population of Latin American respondents is small (only 6%), so additional research would be needed to confirm these findings.

The type of treatment seemed to make a difference. Women who received neoadjuvant chemotherapy – chemotherapy before surgery – and then lymph node removal – were twice as likely to develop lymphedema than their counterparts who had previously had surgery followed by axillary lymph node dissection, the study found.

Barrio said other research has shown that black women are often diagnosed with later-stage breast cancer. Therefore, it is more likely that you will need axillary surgery which may increase the risk of lymphedema. Nevertheless, the black race was the strongest predictor of the development of lymphedema.

Other factors associated with a higher risk of lymphedema were older age and prolonged postoperative time.

The findings will be presented this week at a symposium on breast cancer. Findings presented at medical meetings should be considered preliminary until published in a peer-reviewed journal.

More information

The American National Cancer Institute has more on that lymphedema.

SOURCES: Stephanie Bernik, MD, Head of 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


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