Trial reportInternational journal of radiation oncology, biology, physics2019
Development and Validation of a Nomogram to Predict Lymphedema After Axillary Surgery and Radiation Therapy in Women With Breast Cancer From the NCIC CTG MA.20 Randomized Trial.
Trial report in International journal of radiation oncology, biology, physics, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 28 papers, 3 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
28 citing papers in PubMed, 3 syntheses or guidelines pooled it, 53 citations in OpenAlex.
- Is axillary web syndrome a risk factor for breast cancer-related lymphedema of the upper extremity? A systematic review and meta-analysis.Breast cancer research and treatment · 2024Pooled it
- Prediction models for breast cancer-related lymphedema: a systematic review and critical appraisal.Systematic reviews · 2022Pooled it
- Microsurgical techniques in the treatment of breast cancer-related lymphedema: a systematic review of efficacy and patient outcomes.Breast cancer (Tokyo, Japan) · 2021Pooled it
- Trial
- Using Machine Learning to Predict Breast Cancer-Related Lymphedema Following Axillary Lymph Node Dissection.Annals of surgical oncology · 2026Article
- Dose to the axillary-lateral thoracic vessel junction predicts breast cancer-related lymphedema after postmastectomy radiotherapy: development and temporal validation of NTCP and nomogram models.World journal of surgical oncology · 2026Article
- Noncontrast MRI-based machine learning and radiomics signature can predict the severity of primary lower limb lymphedema.Journal of vascular surgery. Venous and lymphatic disorders · 2025Article
- Machine learning-based personalized risk prediction model for breast cancer-related lymphedema after surgery.Frontiers in oncology · 2025Article
- Nomogram for predicting risk of arm lymphedema following axillary lymph node dissection in breast cancer patients.Frontiers in oncology · 2025Article
- Development and validation of a nomogram for breast cancer-related lymphedema.Scientific reports · 2024Article
- Article
- Factors affecting lymphedema after neoadjuvant chemotherapy and axillary dissection in female breast cancer patients: a retrospective cohort study based on the Chinese population.Frontiers in oncology · 2024Article
- Recent Advances in Therapeutic Modalities Against Breast Cancer-Related Lymphedema: Future Epigenetic Landscape.Lymphatic research and biology · 2023Review
- Feasibility and Clinical Utility of Prediction Models for Breast Cancer-Related Lymphedema Incorporating Racial Differences in Disease Incidence.JAMA surgery · 2023Article
- The influence of axillary surgery and radiotherapeutic strategy on the risk of lymphedema and upper extremity dysfunction in early breast cancer patients.Breast (Edinburgh, Scotland) · 2023Article
- Preoperative and postoperative nomograms for predicting early recurrence of hepatocellular carcinoma without macrovascular invasion after curative resection.BMC surgery · 2022Article
- Validation of a nomogram for predicting the risk of lymphedema following contemporary treatment for breast cancer: a large multi-institutional study (KROG 20-05).Breast cancer research and treatment · 2022Article
- Development and validation of a nomogram to predict the risk of breast cancer-related lymphedema among Chinese breast cancer survivors.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2021Article
- New classifications of axillary lymph nodes and their anatomical-clinical correlations in breast surgery.World journal of surgical oncology · 2021Review
- Review
Corrections and comments
- Commented on by
Authors and funding
8 authors at 3 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeRegional nodal irradiation for women with breast cancer is known to be an important risk factor for the development of upper extremity lymphedema, but tools to accurately predict lymphedema risks for individual patients are lacking. This study sought to develop and validate a nomogram to predict lymphedema risk after axillary surgery and radiation therapy in women with breast cancer. METHODS AND MATERIALS: Data from 1832 women accrued on the MA.20 trial between March 2000 and February 2007 were used to create a prognostic model with National Cancer Institute Common Toxicity Criteria Version 2.0 grade 2 or higher lymphedema as the primary endpoint. Multivariable logistic regression estimated model performance. External validation was performed on data from a single large academic cancer center (N = 785).
resultsIn the MA.20 trial cohort, 3 risk factors were predictive of lymphedema risk: body mass index (adjusted odds ratio, 1.05 per unit body mass index; 95% confidence interval [CI], 1.03-1.08, P < .001), extent of axillary surgery (adjusted odds radio for 8-11 lymph nodes removed, 3.28 [95% CI, 1.53-7.89] P = .004; 12-15 lymph nodes, 4.04 [95% CI, 1.76-10.26] P = .002; ≥16 nodes, 5.08 [95% CI, 2.26-12.70] P < .001), and extent of nodal irradiation (adjusted odds radio for limited, 1.66 [95% CI, 1.08-2.56] P = .02; for extensive, 2.31 [95% CI, 1.28-4.10] P = .004). A nomogram was created from these data that predicted lymphedema risk with reasonable accuracy confirmed by both internal (concordance index, 0.69; 95% CI, 0.64-0.74) and external validation (concordance index, 0.71; 95% CI, 0.66-0.76).
conclusionsThe nomogram created from the MA.20 randomized trial data using clinical information may be useful for lymphedema screening and risk stratification for therapeutic intervention trials.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.