关键词: breast cancer lymph node dissection radiation therapy skin thickening toxicity

Mesh : Adult Aged Axilla / surgery Breast Neoplasms / radiotherapy surgery Epidermis / diagnostic imaging Female Follow-Up Studies Humans Lymph Node Excision / adverse effects Mastectomy, Segmental Middle Aged Prospective Studies Radiotherapy, Adjuvant / adverse effects Time-to-Treatment Ultrasonography Whites

来  源:   DOI:10.1002/jso.25757   PDF(Sci-hub)   PDF(Pubmed)

Abstract:
BACKGROUND: We previously reported a prospective study showing axillary lymph node dissection (ALND) is associated with increased breast skin thickening during and 6 weeks post-radiation therapy (RT), and now report ALND\'s long-term impact at 1 year.
METHODS: Among 66 women who received whole breast RT after lumpectomy, objective ultrasound measurements of epidermal thickness over four quadrants of the treated breast were measured at five time points: before RT, week 6 of RT, and 6 weeks, 6 months, and 1 year post-RT. Skin thickness ratio (STRA) was generated by normalizing for corresponding measurements of the contralateral breast.
RESULTS: A total of 2,436 ultrasound images were obtained. Among 63 women with evaluable data at 1 year, mean STRA significantly increased at 6 months (absolute mean increase of 65%, SD 0.054), and remained elevated at 1 year post-RT (absolute mean increase of 44%, SD 0.048). In multivariable analysis, ALND compared to sentinel lymph node biopsy, longer interval between surgery and RT, increased baseline STRA, and Caucasian race predicted for more severe changes in STRA at 1 year compared to baseline (all P < .05).
CONCLUSIONS: In the setting of whole breast RT, our findings suggest that ALND has long-term repercussions on breast skin thickening.
摘要:
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