Lymphedema following taxane-based chemotherapy in women with early breast cancer.

Mi-Joung Lee, Jane Beith, Leigh Ward, Sharon Kilbreath

Index: Lymphat. Res. Biol. 12(4) , 282-8, (2014)

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Abstract

Taxanes can cause fluid accumulation by increasing extracellular fluid (ECF). Taxane-based regimens are standard of care for early breast cancer, but it is unknown whether they increase the risk of lymphedema. The aim of this study was to describe the incidence of lymphedema, generalized limb edema, and associated symptoms in women receiving adjuvant taxane-based chemotherapy.Women (n=63) recruited after axillary surgery for early breast cancer were assessed prior to anthracycline-based, prior to taxane-based chemotherapy, and 3 weeks and 6 months after completing taxane-based chemotherapy. At each assessment, the inter-limb ECF ratios and intra-limb intracellular fluid to ECF ratios were determined using bioimpedance spectroscopy. Inter-limb arm volume ratios were calculated from arm circumferences measurements. Self-rated symptoms of swelling and pain in the arm on the side of surgery were recorded. In the 53 women who completed assessments, taxane-based chemotherapy increased the ECF volume in both upper and lower limbs, which was not observed after anthracycline-based chemotherapy. The arm on the side of surgery was preferentially affected, indicated by elevated ECF ratios at 3 weeks and 6 months after completing taxane-based chemotherapy with 32% and 23% meeting the criteria for lymphedema at these time-points, respectively. Edema resolved by 6 months following completion of chemotherapy except in the arm on the side of surgery.The incidence of lymphedema in the arm on the side of surgery following taxane-based chemotherapy was increased persisting at least 6 months after ceasing chemotherapy. However, generalized swelling in the legs and opposite arm resolved by 6 months after chemotherapy.