Elevated extracellular fluid in the "at risk" arm from taxane-based chemotherapies in women treated for early breast cancer.

Authors

null

Sharon Lynn Kilbreath

Faculty of Health Sciences, University of Sydney, Sydney, Australia

Sharon Lynn Kilbreath , Jane McNeil Beith , Kathryn M. Refshauge , Leigh C. Ward , Owen Ung , James French , Louise Koelmeyer , Katrina Kastanias , Judy M. Simpson , Jasmine Yee

Organizations

Faculty of Health Sciences, University of Sydney, Sydney, Australia, Sydney Cancer Centre, Royal Prince Alfred Hospital, Camperdown, Australia, Department of Biochemistry, University of Queensland, St. Lucia, Australia, University of Queensland, St Lucia, Australia, Westmead Breast Cancer Institute, Westmead Hospital, Westmead, Australia, Macquarie University Cancer Institute, North Ryde, Australia, Australian School of Advanced Medicine, North Ryde, Australia, School of Public Health, University of Sydney, Camperdown, Australia

Research Funding

No funding sources reported

Background: Taxane-based regimes has improved survival in early breast cancer and now is used routinely. A common side effect is oedema which potentially increases the risk of lymphoedema in the arm after surgery. This has not been assessed prospectively. The aim of this study was to determine the effect of taxane-based regimens on extracellular fluid (ECF) in the arm on the side of surgery. Methods: Women (n=441) aged 56.8 (SD 11.2) years enrolled prior to surgery for early breast cancer and were reassessed within 1 month and 6, 12, and 18 months following surgery. Assessment included bioimpedance spectroscopy which quantifies ECF in each arm and used to derive the ECF ratio. Based on the ECF ratio, women were categorised as having, or not, swelling preferentially in their at risk arm at each time point and having no taxane-based chemotherapy (n=269), paclitaxel (n=73) or docetaxel chemotherapy (n=88). Results: Pre-surgery, the ECF ratio was not significantly different in women who later did or did not receive taxane-based chemotherapy. Following surgery but prior to commencing chemotherapy, 45 (11%) women had increased ECF in their at-risk arm. Both taxane-based chemotherapies and elevated postoperative arm swelling were associated with swelling at each follow-up timepoint (Table). Conclusions: In addition to pre-existing swelling, both taxel chemotherapies were associated with swelling preferentially in the at-risk arm between 6 and 18 months following surgery. Strategies to prevent or minimise this swelling need to be developed.

Associations of chemotherapies and postoperative arm swelling on increased ECF ratio at 6, 12, and 18 months following surgery.
Assessment Characteristics Adjusted odds ratio (95%CI)
6 Months
Taxane
Post-op swelling
No taxane
Paclitaxel
Docitaxel
No swelling
Swelling
1.0
2.9 (1.3 to 6.1)
2.2 (1.0 to 4.9)
1.0
6.4 (3.1 to 13.3)
12 Months
Taxane
Post-op swelling
No taxane
Paclitaxel
Docitaxel
No swelling
Swelling
1.0
1.05 (2.4 to 11.1)
2.5 (1.1 to 5.8)
1.0
7.0 (3.3 to 14.9)
18 Months
Taxane
Post-op swelling
No taxane
Paclitaxel
Docitaxel
No swelling
Swelling
1.0
2.7 (1.2 to 6.1)
2.3 (1.0 to 5.3)
1.0
11.7 (5.6 to 24.5)

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Abstract Details

Meeting

2013 Breast Cancer Symposium

Session Type

Poster Session

Session Title

General Poster Session B

Track

Survivorship and Health Policy,Systemic Therapy

Sub Track

Survivorship

Citation

J Clin Oncol 31, 2013 (suppl 26; abstr 126)

DOI

10.1200/jco.2013.31.26_suppl.126

Abstract #

126

Poster Bd #

C19

Abstract Disclosures