Factors that Influence the Incidence of Brachial Oedema After Treatment of Breast Cancer

Segerström, Knut; Bjerle, Per; Graffman, S.; Nyström, Áke

doi:10.3109/02844319209016016

Cited by 146 publications

(123 citation statements)

References 13 publications

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“…Accumulated lymph in the edematous arm provides a rich culture medium for bacteria. As reported by Segerströ m et al (17), the recurrent infections may be secondary to the edema, rather than the cause of the condition.…”

mentioning

confidence: 76%

“…A correlation between recurrent or late infections and arm edema has been reported in several studies (17,19,20), but it is difficult to accept this as a causative factor for lymphedema. The lymphedematous tissues are extremely sensitive to infections, and any simple burns and puncture wounds can develop into generalized erysipelas, which may produce further lymphatic destruction and blockage (4).…”

mentioning

confidence: 99%

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Risk Factors of Arm Lymphedema in Breast Cancer Patients

Koçak

Overgaard²

2000

Acta Oncologica

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confidence: 76%

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confidence: 99%

Risk Factors of Arm Lymphedema in Breast Cancer Patients

Koçak

Overgaard²

2000

Acta Oncologica

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“…Edwards et al studied the incidence of lymphedema after breast cancer treatment by volumetric method and subjective assessment of swelling and found no significant relationship between axillary irradiation and lymphedema [12]. Apart from surgery and radiotherapy various other risk factors for lymphedema development are described in literature including age, presence of co-morbid conditions, wound infection, obesity, stage of disease and systemic therapy [13][14][15].…”

Section: Discussionmentioning

confidence: 99%

“…The incidence of lymphedema has been reported with a very wide range from 2%-40% in women treated with modified radical mastectomy or breast conserving surgery with no apparent difference between the two surgeries [4,5,[8][9][10][11]. The factors quoted to influence incidence of lymphedema include the level of nodal dissection, the number of nodes removed, the number of involved nodes, presence of extra capsular spread, size and grade of the primary tumor, co-morbid conditions, anthracycline based chemotherapy, axillary irradiation, experience of the surgeon, dominant limb and body mass index [12][13][14][15][16].…”

Section: Introductionmentioning

confidence: 99%

Study of Incidence of Lymphedema in Indian Patients Undergoing Axillary Dissection for Breast Cancer

Pillai

Sharma

Ahmed

et al. 2010

Indian J Surg Oncol

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Lymphedema of the upper extremity, in addition to being unsightly, can be painful, can limit the arm movements, increases the risk of infection and is psychologically distressing, serving as a constant reminder of cancer. 1. To ascertain the incidence of lymphedema in a hospital based population (in patients undergoing axillary dissection for breast cancer. 2. To determine the clinicoepidemilogical factors associated with the occurrence of lymphedema in these patients. For all patients undergoing axillary dissection, arm measurements were taken in the pre-& post-operative period from at least 3 sites; one in the arm, forearm and wrist (points fixed in reference to fixed bony landmarks). Patients included in this study were followed up for at least 12 months. Circumference difference of more than 5% was taken as mild lymphedema; more than 10% as moderate lymphedema and more than 15% as severe lymphedema. Data was analyzed using SPSS 11.0 statistical software. Of the 231 patients in this study mean age was 51.2 years, majority were housewives (71.9%) and postmenopausal (58.5%). Modified radical mastectomy (MRM), was performed on 203 (87.9%) patients. 57.2% patients had positive lymph nodes. The mean number of positive nodes was 6.52. Majority of the patients received chemo and radio therapy. Overall incidence of lymphedema was 41.1%. The definition of 5-10% increase as mild lymphedema may be a bit severe as in most patients with this increase, lymphedema is not clinically apparent. The incidence of moderate and severe lymphedema in our series is only 7.4%. The incidence of clinically significant lymphedema (moderate to severe lymphedema & symptomatic mild lymphedema) was 16.8%. Only axillary irradiation and pathological nodal status (pN3) emerged as significant risk factors for lymphedema development on multivariate analysis. Lymphedema once established is difficult to treat. Combination of axillary dissection with radiation and more nodal positivity seems to predispose to lymphedema. Prevention by means of sentinel node biopsy in early cases, good surgical technique, arm care post surgery, exercises and massage therapy may help reducing the incidence and/or severity.

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“…1 In general, without regard to the individual surgical approach or the elapsed time since treatment, approximately one in four women develops arm edema after treatment for breast carcinoma. 2 Once it is established, lymphedema has an inexorable tendency to progress.…”

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confidence: 99%

Decongestive lymphatic therapy for patients with breast carcinoma‐associated lymphedema

Szuba

Achalu

Rockson

2002

Cancer

189

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BACKGROUNDDisruption of the lymphatic circulation through breast carcinoma‐associated axillary lymph node dissection, with or without radiation therapy, reportedly is the most common cause of lymphedema in developed countries. There is no cure for breast carcinoma‐associated lymphedema. Although intermittent pneumatic compression (IPC) has been acknowledged as a potential component of the multidisciplinary therapeutic strategy in the treatment of patients with breast carcinoma‐associated lymphedema, prospective study of its adjunctive safety and efficacy is required.METHODSIPC was assessed as a component of the initial therapeutic regimen for newly treated patients with breast carcinoma‐associated lymphedema. Twenty‐three patients who had not previously been treated for lymphedema were randomized to receive either decongestive lymphatic therapy (DLT) alone or DLT with daily adjunctive IPC. Patients with stable, treated, breast carcinoma‐associated lymphedema also were assessed in the maintenance phase of therapy. Twenty‐seven patients were randomized either to DLT alone or to DLT coupled with daily IPC. In both studies, objective assessment included serial measurement of volume by water displacement, tissue tonometry to assess elasticity of the skin, and goniometry to measure joint mobility.RESULTSDuring initial treatment, the addition of IPC to standard DLT yielded an additional mean volume reduction (45.3% vs. 26%; P < 0.05). During maintenance DLT alone, there was a mean increase in volume (32.7 ± 115.2 mL); with DLT and IPC, there was a mean volume reduction (89.5 ± 195.5 mL; P < 0.05). In both studies, IPC was tolerated well without detectable adverse effects on skin elasticity or joint range of motion.CONCLUSIONSWhen IPC is used adjunctively with other, established elements of DLT, it provides an enhancement of the therapeutic response. IPC is well tolerated and remarkably free of complications. Cancer 2002;95:2260–7. © 2002 American Cancer Society.DOI 10.1002/cncr.10976

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Factors that Influence the Incidence of Brachial Oedema After Treatment of Breast Cancer

Cited by 146 publications

References 13 publications

Risk Factors of Arm Lymphedema in Breast Cancer Patients

Risk Factors of Arm Lymphedema in Breast Cancer Patients

Study of Incidence of Lymphedema in Indian Patients Undergoing Axillary Dissection for Breast Cancer

Decongestive lymphatic therapy for patients with breast carcinoma‐associated lymphedema

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