ArticleBreast (Edinburgh, Scotland)2023
The influence of axillary surgery and radiotherapeutic strategy on the risk of lymphedema and upper extremity dysfunction in early breast cancer patients.
Article in Breast (Edinburgh, Scotland), 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers.
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Who cites it
11 citing papers in PubMed, 15 citations in OpenAlex.
- Trial
- Axillary Reverse Mapping Improves Quality of Life by Significantly Reducing Clinically Relevant Lymphedema After Axillary Lymph Node Dissection in Older Women with Breast Cancer.Current oncology (Toronto, Ont.) · 2026Article
- Surgical Treatment, Rehabilitative Approaches and Functioning Assessment for Patients Affected by Breast Cancer-Related Lymphedema: A Comprehensive Review.Medicina (Kaunas, Lithuania) · 2025Review
- Preoperative DBT-based radiomics for predicting axillary lymph node metastasis in breast cancer: a multi-center study.BMC medical imaging · 2025Article
- Article
- Regression analysis and validation of risk factors for upper limb dysfunction following modified radical mastectomy for breast cancer patients.American journal of translational research · 2025Article
- Article
- An exploratory study of whether axillary lymph node dissection can be avoided in breast cancer patients with positive lymph nodes.Translational cancer research · 2024Article
- Technical consideration for breast reconstruction in patients requiring neoadjuvant or adjuvant radiotherapy: a narrative review.Annals of translational medicine · 2023Review
- Elevated Levels of Serum Biomarkers Associated with Damage to the CNS Neurons and Endothelial Cells Are Linked with Changes in Brain Connectivity in Breast Cancer Patients with Vestibulo-Atactic Syndrome.Pathophysiology : the official journal of the International Society for Pathophysiology · 2023Article
- RNI Precision Trial Protocol: Optimization of Regional Node Irradiation for Sentinel Lymph Node-positive Breast Cancer Omitting Axillary Dissection Based on Clinical and Genomic Risk Assessment: A Prospective Clinical Trial.Technology in cancer research & treatmentArticle
Corrections and comments
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Authors and funding
10 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeTo explore the risk factors for breast cancer-related lymphedema (BCRL) and upper extremity dysfunction (UED) in patients with early breast cancer after modern comprehensive treatment and to compare the toxicity of different treatment strategies.
methodsFrom 2017 to 2020, a total of 1369 female patients with pT1-3N0-1M0 breast cancer who underwent adjuvant radiotherapy in our centre were retrospectively reviewed. BCRL and UED were identified by the Norman and QuickDASH questionnaires. The incidence, severity and risk factors for BCRL and UED were evaluated.
resultsAfter a median follow-up of 25 months, a total of 249 patients developed BCRL; axillary lymph node dissection (ALND), increased number of dissected nodes, right-sided and hypofractionated radiotherapy containing RNI were found to be significant risk factors (all p values < 0.05). The sentinel lymph node biopsy (SLNB)+ regional nodal irradiation (RNI) group had a significantly lower BCRL risk than the ALND + RNI group (10.8% vs. 32.5%, HR = 0.426, p = 0.020), while there was no significant difference between ALND vs. ALND + RNI or SLNB vs. SLNB + RNI. A total of 193 patients developed UED, and ALND (p = 0.02) was the only significant risk factor. The SLNB + RNI group had a significantly decreased risk of UED compared with the ALND + RNI group (7.5% vs. 23.9%, HR = 0.260, p = 0.001), and there was no significant difference between SLNB vs. SLNB + RNI or ALND vs. ALND + RNI.
conclusionAggressive ALND remains the primary risk factor for BCRL and UED while RNI does not. Thus, replacing ALND with tailored radiotherapy would be an effective preventive strategy in early breast cancer patients.
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