ArticleEuropean journal of breast health2025
Lymphedema and Axillary-Lateral Thoracic Vessel Juncture Irradiation: A Clinical Dilemma.
Article in European journal of breast health, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Objective: Regional nodal irradiation (RNI) is one of the main causes of breast cancer-related lymphedema (BCRL). However, studies on the relationship between the radiation dose to the axillary-lateral thoracic vessel juncture (ALTJ) region and BCRL have reported conflicting results. Based on these findings, we aimed to evaluate the clinical relevance of the dose to the ALTJ region in our patient cohort. Materials and Methods: Patients diagnosed with breast cancer and who were treated at Koç University Hospital between 2016 and 2022 and received RNI were included. BCRL was defined as a difference in arm circumference between the ipsilateral and contralateral limb >2.5 cm at any single encounter or ≥2 cm on ≥2 visits. ALTJ was retrospectively contoured, and doses were recorded as equivalent dose (α/β = 3). Results: Of the 129 patients (median age 49 years) who met the inclusion criteria, 12 (9.3%) had lymphedema. Two-thirds of the patients (66.7%) were stage II, and one-third (33.3%) were stage III. The median follow-up was 22 months. The median (range) ALTJ D Conclusion: There is insufficient data to define ALTJ as an OAR for decreasing BCRL risk. It is not appropriate to define dose and target based on ALTJ. Prospective studies with larger patient populations are needed to clarify the relationship between ALTJ and lymphedema.
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