The risk of developing skin cancer may be twofold for patients with lymphedema, according to a recent study published by Anand et al in Mayo Clinic Proceedings. The new findings may contribute to growing information linking lymphedema to localized changes in immunity and a predisposition for cancer.
Background
Lymphedema occurs when the accumulation of protein-rich fluids of the immune system cause swelling of the limbs. The condition can be caused by surgery or cancer therapies that remove or damage the lymph nodes or, less commonly, by inherited diseases.
Skin cancer is the most common cancer type across the world; however, few studies have looked at the prevalence of lower-extremity skin cancer.
“Patients with lymphedema are not screened routinely by dermatologists, and inadequate screening may lead to delayed diagnosis and treatment,” explained senior study author Afsaneh Alavi, MD, a dermatologist at the Mayo Clinic.
Study Methods and Results
In the new study, investigators examined the data of 4,437 patients who were diagnosed with lower-extremity lymphedema between 2000 and 2020.
The investigators found that compared with controls, patients with lymphedema had an increased risk of all common types of skin cancer—including melanoma and angiosarcoma—and a significantly higher frequency of developing basal cell carcinoma and squamous cell carcinoma on the lower extremities. Among the patients who had lymphedema in one leg, that extremity was nearly three times as likely to develop skin cancer compared with the other leg.
Conclusions
"Our findings suggest the need for a relatively high degree of suspicion of skin cancer at sites with lymphedema. There is a need for raising awareness in clinicians seeing patients with lymphedema, and these patients may need regular skin cancer screenings, since early detection of skin cancer is critical,” concluded Dr. Alavi.
Disclosure: For full disclosures of the study authors, visit mayoclinicproceedings.org.
