Integrating Biological Advances Into the Clinical Management of Breast Cancer Related Lymphedema

Marco Invernizzi, Gianluca Lopez, Anna Michelotti, Konstantinos Venetis, Elham Sajjadi, Leticia De Mattos-Arruda, Michele Ghidini, Letterio Runza, Alessandro de Sire, Renzo Boldorini, Nicola Fusco

Research output: Contribution to journalReview articlepeer-review

Abstract

Breast cancer-related lymphedema (BCRL) occurs in a significant number of breast cancer survivors as a consequence of the axillary lymphatics' impairment after therapy (mainly axillary surgery and irradiation). Despite the recent achievements in the clinical management of these patients, BCRL is often diagnosed at its occurrence. In most cases, it remains a progressive and irreversible condition, with dramatic consequences in terms of quality of life and on sanitary costs. There are still no validated pre-surgical strategies to identify individuals that harbor an increased risk of BCRL. However, clinical, therapeutic, and tumor-specific traits are recurrent in these patients. Over the past few years, many studies have unraveled the complexity of the molecular and transcriptional events leading to the lymphatic system ontogenesis. Additionally, molecular insights are coming from the study of the germline alterations involved at variable levels in BCRL models. Regrettably, there is a substantial lack of predictive biomarkers for BCRL, given that our knowledge of its molecular milieu remains extremely puzzled. The purposes of this review were (i) to outline the biology underpinning the ontogenesis of the lymphatic system; (ii) to assess the current state of knowledge of the molecular alterations that can be involved in BCRL pathogenesis and progression; (iii) to discuss the present and short-term future perspectives in biomarker-based patients' risk stratification; and (iv) to provide practical information that can be employed to improve the quality of life of these patients.

Original languageEnglish
Article number422
JournalFrontiers in Oncology
Volume10
DOIs
Publication statusPublished - Apr 2 2020

Keywords

  • breast cancer
  • breast cancer related lymphedema
  • genetics
  • pathobiology
  • quality of life
  • survivorship

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

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