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- Title
Incidence and risk of arm oedema following treatment for breast cancer: a three-year follow-up study.
- Authors
B. Clark; J. Sitzia; W. Harlow
- 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 =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 1.334.47), mastectomy (vs. wide local excision or lumpectomy) (RR 2.04, 95%CI 1.183.54), and BMI=26 (vs. BMI 1926) (RR 2.02, 95%CI 1.113.68) 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.
- Subjects
BREAST cancer; CANCER treatment; CANCER patients; LYMPH circulation disorders; SURGERY
- Publication
QJM: An International Journal of Medicine, 2005, Vol 98, Issue 5, p343
- ISSN
1460-2725
- Publication type
Article
- DOI
10.1093/qjmed/hci053