Breast cancer treatment results in lymphedema in about 10 to 35% of patients, especially in patients who undergo surgical resection of the regional lymph nodes along with radiation to the axilla. There have been attempts to improve the therapy for breast cancer and it is our hope that with better treatments for breast cancer, we can reduce the need for extensive surgery and radiation and reduce the incidence of lymphedema. One of the active areas of research in breast cancer therapy is bone marrow and stem cell transplant.

Bone marrow transplants were once thought to offer hope for patients with advanced breast cancer; however, recent studies have not supported the benefit of bone marrow transplant over standard chemotherapy. As a result, a more advanced version of bone marrow transplant has been under investigation. In the more advanced version of bone marrow transplant, stem cells, which are immature bone marrow cells, are harvested from the patient's blood rather from the bone marrow. The stem cells from the blood are easier to harvest and are more prolific sources of immune cells. The stem cells are reinfused after the high-dose chemotherapy treatment and produce a large number of mature immune cells. Stem cell transplant is an easier and more effective than bone marrow transplant and it was felt that this technique may be the missing key needed to help improve survival among patients suffering from advanced breast cancer.

The new stem cell transplant method was compared to standard chemotherapy and the results of this study were recently published in the New England Journal of Medicine. Unfortunately, the studies did not find an advantage for stem cell transplant compared to standard chemotherapy. In fact, 3 years after treatment, there were slightly more survivors in the standard therapy group than in the group of patients who received the stem cell transplant. In addition, side-effects including suppression of the immune system and anemia were more common in the patients who received the stem cell transplant.

While this study did not prove that stem cell transplants are better than standard chemotherapy, additional studies are underway and scientists and physicians are working to find an even better methods to treat breast cancer. I believe that better treatments for breast cancer will help us win the battle against lymphedema.

Tony Reid MD Ph.D
Dr. Reid's Corner
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Joint Commission