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Predicting the 5-Year Risk of Getting Lymphedema

Posted on the 12 September 2011 by Jean Campbell

There is now a free online statistical tool that can predict the 5-year risk of a breast cancer survivor getting lymphedema following surgery. The online tool calculates with 70% accuracy.

Jose Bevilacqua,MD, Ph.d, of Hospital Sirio Libanes in Sao Paulo, Brazil and his colleagues  reported on the results of a study using this tool at Multidisciplinary Breast Cancer Symposium  in San Francisco this past week.

Dr. Bevilacqua’s study used a prospective cohort of 1,054 women followed for lymphedema after axillary lymph node dissection as part of surgery for breast cancer done at the Brazilian National Cancer Institute from Aug. 2001 to Nov. 2002.

The five-year cumulative incidence of lymphedema was 30.3%.

Significant independent predictors in the statistical models included:

  • For preoperative prediction, age, body mass index (BMI), and number of cycles of neoadjuvant chemotherapy ( chemotherapy administered before a standard treatment such as surgery)

  • For prediction within six months of surgery, age, BMI, number of cycles of neoadjuvant or adjuvant chemotherapy, level of axillary lymph node dissection, and extent of radiotherapy field

  • For prediction beyond six months after surgery, all the earlier factors as well as development of seroma (a collection of serum in the body, producing a tumor-like mass) and evidence of early edema (swelling caused by excess fluid trapped in your body’s tissues)

The researchers cautioned that their nomograms (computerized tools) have yet to be validated on an independent cohort of patients,

“This kind of risk prediction is an important step forward that could have real practical implications for patients,” said Andrew D. Seidman, MD, of Memorial Sloan-Kettering Cancer Center in New York City during a telebriefing prior to the Symposium.

“It allows us to identify patients who can then be appropriately triaged for early intervention and perhaps for clinical trials aimed at preventing what many consider inevitable [lymphedema],” he told reporters.

The online tool, found at, is hosted by the Cleveland Clinic, which collaborated on the project. The Web site was available temporarily during the conference (from September 8 through 10) and will be permanently accessible after planned publication of the study.

Source: MedPage Today, 9/8/2011, Crystal Phend,   Multidisciplinary Breast Cancer Symposium, San Francisco

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