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QJM. 2005 May;98(5):343-8. Epub 2005 Apr 8.

Incidence and risk of arm oedema following treatment for breast cancer: a three-year follow-up study.

Author information

1
Worthing and Southlands Hospitals NHS Trust, Worthing Hospital, West Sussex, UK.

Abstract

BACKGROUND:

Breast-cancer-related lymphoedema is a chronic condition with estimates of incidence ranging from 6 to 83%. Lymphoedema has been associated with a variety of risk factors. However, this evidence has suffered from methodological weaknesses, and so has had little impact upon clinical practice.

AIM:

To examine incidence and risk factors [hospital skin puncture, surgical procedure, Body Mass Index (BMI), age, axillary node status, number of axillary nodes removed, radiotherapy and surgery on dominant side] for breast cancer-related arm lymphoedema.

DESIGN:

Prospective observational study, with measurement of limbs pre-operatively and at regular intervals post-operatively.

METHODS:

We recruited 251 women who had surgical treatment for breast cancer that involved sampling, excision or biopsy of axillary nodes, aged > or = 18 years, and free of advanced disease and psychological co-morbidities. Of these, 188 (74.9%) were available for 3-year follow-up.

RESULTS:

At follow-up, 39 (20.7%) had developed lymphoedema. Hospital skin puncture (vs. none) (RR 2.44, 95%CI 1.33-4.47), mastectomy (vs. wide local excision or lumpectomy) (RR 2.04, 95%CI 1.18-3.54), and BMI > or = 26 (vs. BMI 19-26) (RR 2.02, 95%CI 1.11-3.68) were the only significant risk factors.

DISCUSSION:

Lymphoedema remains a significant clinical problem, with 1:5 women in this sample developing the condition following treatment for breast cancer. Risk factors are identified in the development of lymphoedema that should be taken into account in clinical practice.

PMID:
15820971
DOI:
10.1093/qjmed/hci053
[Indexed for MEDLINE]

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