Assesment of Lymphedema Risk Following Lymph Node Dissection and Radiation Therapy for Primary Breast Cancer
Abstract
Lymphedema is a common, chronic, and potentially devastating complication of primary breast cancer therapy. Radiation increases patients lymphedema risk up to 36% as conventional fields irradiate vital lymphatic tissues. Fusion imaging technologies that combine anatomical and physiological data, e.g. SPECT/CT, may identify lymphatics critical for arm drainage and allow the creation of conformal radiation treatment fields that minimize the exposure of lymph nodes (LNs) and vessels while delivering therapeutic doses to target tissues. This study uses SPECT/CT scanning to localize lymphatics critical for arm drainage, and has established the feasibility of fusing SPECT/CT images with the CT scans used for radiation planning, thereby creating the opportunity to spare essential LNs needless radiation. Further, precise quantification of the dosimetry delivered to LNs draining the arm has revealed harmful levels of incidental irradiation with tangent beam configurations and subtherapeutic exposure with 4-field configurations. Data collection is complete, however interpretation and analysis of follow up SPECT/CT scans is ongoing. Data analysis will address the hypothesis that increased arm volume correlates with high levels of radiation dosimetry delivered to the LNs draining the arm. Additionally, data analysis will determine whether the radiation dose delivered to specific LNs is inversely correlated with radiolabeled tracer uptake, a surrogate measure for functional status, on follow up scans. The proposed study realizes the BCRP goals by elucidating a novel means of refining breast cancer treatment minimize patients' risk of developing the most prevalent and dreaded complication of conventional therapy, lymphedema.
Document Details
- Document Type
- Technical Report
- Publication Date
- Sep 01, 2008
- Accession Number
- ADA491730
Entities
People
- Andrea L. Cheville
Organizations
- Mayo Clinic