Supraclavicular irradiation is a risk factor of lymphedema in breast cancer patients treated with axillary lymph node dissection and taxane-containing regimens

Purpose: Breast cancer-related lymphedema (LE) significantly impairs the patients’ quality of life. Axillary lymph node dissection (ALND) is a strong risk factor for LE in breast cancer surgery. In addition, postoperative administration of docetaxel (DTX) has been reported to be a risk factor for LE in patients who undergo ALND. Herein, we performed a secondary analysis of the risk of objective LE after ALND using data from our previous study. Methods: Patients who visited the medical follow-up clinic between 12 November 2018 and 11 January 2019 and at least one year postoperatively were eligible for this study. Objective LE was defined as a difference of at least 2 cm between the affected and unaffected arms or when therapeutic intervention had already been performed for LE. The risk factors for objective LE according to taxane-containing regimen, radiation therapy, and body mass index and the effects of a taxane-containing regimen followed by supraclavicular irradiation on LE were examined. Results: Objective LE was observed in 52 patients (24%). Univariate and multivariate analyses showed that supraclavicular field irradiation was a statistically significant risk factor for objective LE. The sequential use of taxane-containing regimen and supraclavicular RT was more likely to be a risk factor for LE than ALND alone. Conclusion: The risk for LE was more likely to be higher with the sequential use of taxane-containing chemotherapy and supraclavicular field irradiation. Therefore, management of LE is important these cases.