# Mechanisms of racial disparity in breast cancer-related lymphedema

> **NIH NIH R01** · SLOAN-KETTERING INST CAN RESEARCH · 2024 · $697,823

## Abstract

PROJECT SUMMARY/ABSTRACT
 This proposal is significant because we aim to study the cellular mechanisms that regulate the
increased risk of breast cancer-related lymphedema (BCRL) development in Black women. This is important
because BCRL is a highly morbid disease that causes chronic and progressive arm swelling. Patients who
develop BRCL have diminished quality of life, require life-long care with compression garments, and can
develop recurrent infections that require hospitalization. Due to the high prevalence of breast cancer, BCRL is
the most common form of lymphedema in developed countries, afflicting 20–35% of women who undergo
axillary lymph node dissection (ALND).
 To identify risk factors for BCRL, our group has prospectively followed 276 women with arm
measurements before and after ALND for 2 years. We have found that Black women have the highest risk of
BCRL even after adjusting for confounding variables. In our study, Black race increased the risk of BCRL
development by >3.6 fold compared with White race. These findings are supported by two other published
studies reporting increased risk of BCRL development in Black women who undergo ALND for breast cancer.
Thus, while there is strong evidence that Black women have a significantly increased risk of developing BCRL,
the cellular mechanisms that regulate this risk remain unknown. This gap in our knowledge is important and a
major barrier to developing novel therapies that prevent or treat lymphedema in this patient population. In
addition, understanding how Black race increases the risk of BCRL may shed light on the mechanisms that
regulate the pathophysiology of this disease in general. Based on prior research and our preliminary studies,
our central hypothesis is that Black women have an increased risk of developing BCRL due to a baseline
increased propensity for inflammation and fibrosis. We propose to test this hypothesis using two Specific Aims.
In Aim 1, we will analyze how racial disparities modulate inflammatory responses following lymphatic injury.
This hypothesis is based on the finding that the pathophysiology of lymphedema is linked to chronic
inflammation and development of T-helper 2 (Th2)-biased immune responses. Black patients have a
propensity for inflammation in other pathological settings, suggesting that these differences may also
contribute to an increased risk for developing BCRL. In Aim 2, we will test the hypothesis that Black women
have an increased fibrotic response to lymphedema. This hypothesis is based on the observation that fibrosis
is a key pathological feature of lymphedema and plays a major role in regulating lymphatic function. Black
individuals have an increased potential for fibrosis in a variety of pathological settings including inflammatory
skin disorders.

## Key facts

- **NIH application ID:** 10757725
- **Project number:** 5R01CA278599-02
- **Recipient organization:** SLOAN-KETTERING INST CAN RESEARCH
- **Principal Investigator:** Andrea Barrio
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $697,823
- **Award type:** 5
- **Project period:** 2023-01-01 → 2027-12-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10757725

## Citation

> US National Institutes of Health, RePORTER application 10757725, Mechanisms of racial disparity in breast cancer-related lymphedema (5R01CA278599-02). Retrieved via AI Analytics 2026-05-25 from https://api.ai-analytics.org/grant/nih/10757725. Licensed CC0.

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