NIH awards $452,218 for research on proinflammatory biomarkers and post-breast cancer lymphedema

The research aims to investigate breast cancer patients' susceptibility to lymphedema by evaluating biomarker patterns and genetic factors

New York University College of Nursing (NYUCN) received a two-year, $452,218.00 grant from the national Institutes of Health (NIH) to research "Proinflammatory Biomarkers and Post-Breast Cancer Lymphedema." Post-breast cancer lymphedema (LE), a syndrome of abnormal swelling and multiple distressing symptoms, is caused by injuries to the lymphatic system from cancer treatment. As advances in cancer treatment lengthen survival, LE has emerged as a high-impact long-term morbidity that profoundly impairs survivors' quality of life.

According to Fu, the purpose of this exploratory project is to prospectively examine levels and patterns of proinflammatory biomarkers and genetic variations in relation to limb volume change measured with the infra-red perometer-350S over a 12-month period in breast cancer survivors who are at risk for lymphedema.

"Among the 2.5 million breast cancer survivors in the U.S. more than 40% of them have developed lymphedema," said NYUCN Assistant Professor Mei Fu, PhD, RN, APRN-BC. "All women undergoing breast cancer treatment are at lifetime risk for lymphedema."

While removal of lymph nodes, surgery, and radiation are the major causal factors for lymphedema, cancer treatment is necessary for life-saving. Recent research has revealed that inflammation-infection and higher body mass index (BMI) are the main predictors of lymphedema besides treatment-related risk.

Unfortunately, these studies did not evaluate biomarkers known for inflammation, and thus the role of inflammation-infection in limb volume change and lymphedema development could not be ascertained.

Elevated levels of proinflammatory biomarkers have been speculated to be associated with inflammation in patients with lymphedema. Moreover, genetic variations may be one of the important factors that influence breast cancer survivors' responses to inflammatory processes and vulnerability to lymphedema, including survivors' responses to treatment-related trauma (such as surgery and radiation) and triggering factors (such as infection, burns, minor injuries, and higher BMI or obesity).

The project will employ a prospective, descriptive, and repeated-measure design. A sample of 120 women who are newly diagnosed and treated for invasive breast cancer will be recruited. Data will be collected to evaluate levels and patterns of proinflammatory biomarkers and genotypes known for inflammation in relation to limb volume change.

"This project is an important first step toward gaining necessary knowledge and insights into breast cancer survivors' susceptibility, which may help to identify survivors at higher risk based on individual survivors' biomarker patterns and genetic factors," said Fu. "Findings of the project are fundamental in developing and testing more intense and personalized interventions to prevent and treat LE among the breast cancer survivors."