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Full axillary lymph node dissection and increased breast epidermal thickness 1 year after radiation therapy for breast cancer
Author(s) -
Lin Jolinta Y.,
Yang Xiaofeng,
Serra Monica,
Miller Andrew H.,
Godette Karen D.,
Kahn Shan T.,
Henry Simone,
Brown Gabrielle,
Liu Tian,
Torres Mylin A.
Publication year - 2019
Publication title -
journal of surgical oncology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.201
H-Index - 111
eISSN - 1096-9098
pISSN - 0022-4790
DOI - 10.1002/jso.25757
Subject(s) - medicine , axillary lymph node dissection , breast cancer , lymphedema , lumpectomy , lymph node , prospective cohort study , sentinel lymph node , radiation therapy , surgery , mastectomy , radiology , cancer
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.