SABCS: Black Race Predicts Breast Cancer BCRL, 3.85 times More Likely-Related Lymphedema

Other independent predictors of BCRL include receipt of neoadjuvant chemotherapy, older age, and increasing time since surgery.

Black race is the strongest predictor of breast cancer-related lymphedema (BCRL) after axillary lymph node dissection (ALND), according to a study presented at the annual San Antonio Breast Cancer Symposium held in San Antonio.

Andrea V. Barrio, M.D., from the Memorial Sloan Kettering Cancer Center in New York City, and colleagues examined the impact of race and ethnicity on BCRL incidence and severity in a prospective cohort study of patients treated with ALND. Participants were evaluated at baseline, postoperatively, and six-month intervals; 268 participants had at least one longitudinal measurement after baseline and were included.

The researchers found that the likelihood of receiving breast-conserving surgery and nodal radiotherapy was increased for Black and Hispanic women. Fifty women developed BCRL at a median follow-up of 1.62 years.

The 18-month BCRL rate was 15.9 percent overall, with a higher incidence for Black and Hispanic versus Asian and Caucasian women (18-month rates, 30.9, 20.2, 10.6, and 11.8 percent, respectively). Black race was the strongest predictor of BCRL development in a multivariable analysis (odds ratio, 4.41 compared with Caucasian).

Other factors independently predicting the development of BCRL included receipt of neoadjuvant chemotherapy, older age, an increasing number of lymph nodes removed, and a longer follow-up interval. Compared with Caucasian women, Black women were 3.85 times more likely to have a higher relative volume change from baseline when assessing BCRL severity; no difference was identified in Hispanic and Asian women.

“Further work should address the biologic mechanisms behind racial disparities in the risk of BCRL and possible preventive strategies,” the authors write.

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