Another day, another study on lymphedema risk. And this one by the most aptly-named first-author yet. This substudy of ACOSOG Z1071, which enrolled women with clinically-node(+) breast cancer receiving neoadjuvant chemo followed by full axillary dissection, prospectively measured arm sizes and symptoms with an aim to tease out the tells of patients most likely to develop lymphedema. Among the 486 women with available info for this analysis, over half experienced a volume increase of >10% at 3 years and over one-third an increase >20%. Once again, the factor most linked to development of lymphedema symptoms was obesity, defined here as a BMI >30. For volume increases >20% that factor was length of neoadjuvant chemo. What you will refreshingly fail to see highlighted as a contributor: Radiation. TBL: As the authors put it, there’s room to share in the prevention of lymphedema, which “is not only the responsibility of the surgeon and the radiation [oncologist] but also the patient and the medical oncologist.” | Armer, JAMA Surg 2019


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