Assessment of Lymphedema Risk Following Lymph Node Dissection and Radiation Therapy for Primary Breast Cancer; Annual summary rept. 11 Aug 2006-10 Aug 2007

摘要

Lymphedema is a common complication of primary breast cancer therapy. It is a chronic insidiously progressive and potentially devastating condition. Radiation increases patients lymphedema risk as conventional fields encompass functioning lymphatics. Fusion imaging technologies that combine anatomical and physiological data may identify these lymphatics and allow tailoring of radiation fields to minimize radiation exposure while preserving regional tumor control. This study uses SPECT scanning to localize lymphatics critical for arm drainage after surgical removal of axillary lymph nodes. The study has established the feasibility of using SPECT images to identify critical lymph nodes on high resolution CT scans used in radiation simulation. Furthermore the study has demonstrated that this technique allows precise quantification of radiation dosimetry delivered to lymph nodes critical for arm drainage. The study will test the hypothesis that increased arm volume correlates with high levels of radiation dosimetry delivered to critical lymph nodes. The fact that higher doses of radiation and larger radiation ports are associated with an increased incidence of lymphedema (volume up arrow > = 150ml.) particularly severe lymphedema (volume arrow up > = 400ml.) supports this hypothesis. The proposed study realizes the BCRP goals by elucidating a novel means of refining breast cancer treatment to minimize patients risk of developing the most prevalent and dreaded complication of conventional therapy lymphedema.