A groundbreaking study published in JAMA Network in March 2024 by Dr. Andrea Barrio and colleagues from Memorial Sloan Kettering Cancer Center (MSK) has uncovered significant new insights into lymphoedema risk factors. The research points to race and ethnicity as key factors influencing the development of lymphoedema in women who have undergone axillary lymph node dissection (ALND) as part of breast cancer treatment.
Exploring Race as a Risk Factor for Lymphoedema
Lymphoedema, a condition marked by the swelling of limbs, is a known complication for breast cancer survivors, particularly after ALND, a procedure that involves removing lymph nodes from the armpit. While certain risk factors, like obesity, have been well-established, the role of race and ethnicity had not been thoroughly explored until now.
Dr. Barrio and her team set out to address this gap by conducting a prospective study, where 276 breast cancer patients of varying racial backgrounds were monitored for two years. The goal was to determine whether race and ethnicity influenced the risk of developing lymphoedema, a condition that can take months to develop after surgery.
Key Findings: Black and Hispanic Women at Higher Risk
The study found some striking patterns regarding race and lymphoedema. Overall, 25% of the women in the study developed lymphoedema, a rate consistent with prior research. However, the risk of developing lymphoedema varied significantly by race:
- 39% of Black women developed lymphoedema
- 28% of Hispanic women developed lymphoedema
- 23% of Asian women developed lymphoedema
- 21% of White women developed lymphoedema
These results suggest that Black women have the highest risk, followed by Hispanic and Asian women. While the risk for white women was lower, it was still notable.
Race as a Strong Predictor of Lymphoedema
Even after adjusting for other known risk factors such as body mass index (BMI) and the number of lymph nodes removed, race remained a strong independent predictor. In fact, Black women were found to be 3.5 times more likely to develop lymphoedema than white women, highlighting the significant racial disparities in outcomes after breast cancer surgery.
However, Dr. Barrio noted that the findings for Hispanic women were based on a smaller sample size (only 16 patients), meaning more research is needed to confirm the trends for this group.
Implications for Healthcare and Future Research
This study represents a significant step forward in understanding the complexities of lymphoedema risk. As Dr. Barrio pointed out, this is the first time race has been systematically studied as a predictor of lymphoedema development in a prospective, long-term setting.
The findings underscore the importance of tailoring prevention and treatment strategies based on individual risk factors, including race. Dr. Barrio emphasized that as research advances, identifying women at the highest risk could lead to more effective treatments and interventions to reduce the burden of lymphoedema in breast cancer survivors.
The study’s insights open the door for more targeted research, particularly to explore the underlying causes of these racial disparities and to develop strategies to minimize risk for women of all backgrounds. By improving our understanding of lymphoedema, healthcare providers can offer more personalized care and potentially reduce the prevalence of this debilitating condition in high-risk populations.
