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Surgeon Volume Has No Effect on Lymphoedema Occurrence in Older Patients With Breast Cancer: Presented at SSO By Jill Stein ST. LOUIS, Mo -- March 7, 2010 -- Five years after breast cancer surgery, 1 in 5 older breast cancer patients have self-reported lymphoedema, researchers announced here on March 6 at the 2010 Society of Surgical Oncology Annual Cancer Symposium (SSO). The results also showed no link between surgeon volume and the development of lymphoedema in this population. Tina Yen, MD, Medical College of Wisconsin, Milwaukee, Wisconsin, and colleagues conducted a study to determine the relative contribution of surgeon case volume on the development of lymphoedema in older breast cancer survivors. The investigators had hypothesised that surgeon volume, as a surrogate for surgeon technique, would be an independent predictor of lymphoedema, and there have been no studies evaluating the role of surgeon volume on the development of lymphoedema, Dr. Yen said. For their study, the researchers analysed responses to telephone surveys conducted in 1,812 women who had been operated on by 862 surgeons at 365 hospitals. The women ranged in age from 65 to 89 years and had their initial breast cancer surgery in 2003. Overall, 368 women, or 20%, had self-reported lymphoedema at a median of 60 months after their surgery. Lymphoedema was considered present if the woman answered “yes” to either of the following questions: 1) Has your doctor ever told you that you have lymphoedema or arm oedema? 2) Since surgery, have you had any hand or arm swelling on the side of your first breast cancer surgery that you do not have on the other side? High-volume surgeons were more likely to perform a sentinel lymph node biopsy (71% vs 43%; P < .001). High- volume surgeons were surgeons performing at least 14 breast cancer operations per year while low-volume surgeons were surgeons performing <7 breast cancer surgeries annually. Among high- and low-volume surgeons, there was no difference in the number of lymph nodes removed with a sentinel node biopsy (mean of 2.7 vs 2.7; P = .96) or axillary lymph node dissection (mean of 7.8 vs 9.4; P = .06). The extent of axillary surgery (the removal of >5 lymph nodes) was the most important predictor of lymphoedema. There was no relationship between surgeon volume and lymphoedema development. Dr. Yen said that additional studies would examine the relationship between other surgeon characteristics and the development of lymphoedema. [Presentation title: The Effect of Surgeon Volume on Lymphedema Development in Older Breast Cancer Women. Abstract 277] E-mail this page to a friend or colleague! To print, use this version