Preoperative assessment of cancer patients enables early diagnosis, treatment of lymphedema

NIH, National Naval Medical Center, George Mason University study published in journal Cancer demonstrates importance of physicians' shift to baseline measures and ongoing 'surveillance' model for successful management of common, debilitating condition

BETHESDA, Md., April 30, 2008 – The preoperative assessment of breast cancer patients for subclinical lymphedema enables clinicians to establish a baseline, which serves to enable the early diagnosis and successful treatment of the debilitating condition, according to data from a five-year study published this week in the online edition of the journal Cancer (http://www3.interscience.wiley.com/cgi-bin/abstract/118821880/ABSTRACT).

In a study conducted by the National Institutes of Health (NIH) and the National Naval Medical Center, in collaboration with faculty and students from the University of Michigan-Flint and George Mason University, researchers measured the upper limb volume of 196 newly diagnosed breast cancer patients from 2001 to 2006 to establish a baseline prior to surgery. At designated postoperative intervals, the researchers took repeated measurements as part of a “surveillance” model to monitor for possible impairments related to breast cancer treatment--such as lymphedema--as opposed to treating therapy-related problems after they occur. Using the surveillance approach, the investigators demonstrated that a short trial of compression garments effectively treated subclinical lymphedema when it was detected early. Forty-three, or 22 percent, of the 196 breast cancer patients in the study developed subclinical lymphedema, as defined by a change in limb volume of >75cc; and all subjects showed a significant mean volume reduction to very near their pre-surgical “normal” state. All subjects were able to maintain this level for an average of 4.8 months, and none of the patients demonstrated progression of the condition in the follow-up period.