Special scan may help reduce lymphedema

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Integrating single photon emission computerized tomography (SPECT) with computerized tomography (CT) to plan radiotherapy for breast-cancer patients may offer substantial protection against lymphedema, which affects up to 70% of breast-cancer survivors.

The combined scan's usefulness is rooted in its ability to pinpoint the precise location of the lymph nodes that are critical to the removal of fluid from the arm, and thus critical to preventing the development of lymphedema. These nodes can then be blocked to the extent possible from x-ray beams delivered to the chest.

In their small study of 22 patients—reported at the 33rd Annual CTRC-AACR San Antonio Breast Symposium (www.sabcs.org)—a team of Mayo Clinic radiation oncologists described how this individualized approach to postsurgical irradiation reduced by 55% the number of fluid-removal lymph nodes that received damaging radiation doses (www.abstracts2view.com/sabcs10/view.php?nu=SABCS10L_1220).

“In an effort to deliver therapeutic doses of radiation to the breast, lymph nodes under the arm are innocent bystanders that often are irrevocably harmed,” pointed out lead investigator Andrea Cheville, MD, in a statement announcing her team's findings. “Minimizing harm to these nodes during breast cancer treatment is the most effective way we have seen to reduce women's risk of developing lymphedema.”

With lymphedema being a critical concern of breast-cancer survivors, noted Dr. Cheville, “Developing a more individualized approach to irradiation is greatly needed.”
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