Incidence, Treatment Costs, and Complications of Lymphedema After Breast Cancer Among Women of Working Age: A 2-Year Follow-Up Study

Shih, Ya Chen Tina; Xu, Ying; Cormier, Janice N.; Giordano, Sharon H.; Ridner, Sheila H.; Buchholz, Thomas A.; Perkins, George H.; Elting, Linda S.

doi:10.1200/jco.2008.18.3517

Cited by 399 publications

(333 citation statements)

References 43 publications

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“…Only 1 study in this group used objective measurement methods (circumference), whereas the remainder assessed lymphedema subjectively. The length of follow-up ranged from 9 to 115 months, and the median quality score for these studies was 5 (range, [3][4][5][6][7][8][9].…”

Section: Type Of Malignancymentioning

confidence: 99%

Lymphedema beyond breast cancer

Cormier

Askew

Mungovan

et al. 2010

Cancer

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413

170

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BACKGROUND: Secondary lymphedema is a debilitating, chronic, progressive condition that commonly occurs after the treatment of breast cancer. The purpose of the current study was to perform a systematic review and meta-analysis of the oncology-related literature excluding breast cancer to derive estimates of lymphedema incidence and to identify potential risk factors among various malignancies. METHODS: The authors systematically reviewed 3 major medical indices (MEDLINE, Cochrane Library databases, and Scopus) to identify studies that included a prospective assessment of lymphedema after cancer treatment. Studies were categorized according to malignancy, and data included treatment, complications, lymphedema measurement criteria, lymphedema incidence, and followup interval. A quality assessment of individual studies was performed using established criteria for systematic reviews. Bayesian meta-analytic techniques were applied to derive summary estimates when sufficient data were available. RESULTS: A total of 47 studies (7779 cancer survivors) met inclusion criteria: melanoma (n ¼ 15), gynecologic malignancies (n ¼ 22), genitourinary cancers (n ¼ 8), head/neck cancers (n ¼ 1), and sarcomas (n ¼ 1). The overall incidence of lymphedema was 15.5% and varied by malignancy (P < .001): melanoma, 16% (upper extremity, 5%; lower extremity, 28%); gynecologic, 20%; genitourinary, 10%; head/neck, 4%; and sarcoma, 30%. Increased lymphedema risk was also noted for patients undergoing pelvic dissections (22%) and radiation therapy (31%). Objective measurement methods and longer follow-up were both associated with increased lymphedema incidence. CONCLUSIONS: Lymphedema is a common condition affecting cancer survivors with various malignancies. The incidence of lymphedema is related to the type and extent of treatment, anatomic location, heterogeneity of assessment methods, and length of follow-up. Cancer 2010;116:5138-49.

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Section: Type Of Malignancymentioning

confidence: 99%

Lymphedema beyond breast cancer

Cormier

Askew

Mungovan

et al. 2010

Cancer

Self Cite

413

170

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“…Incidence of secondary arm lymphedema varies from 5 to 56 percent [4,[7][8][9][10][11][12]. About 60 percent of patients who undergo axillary lymph node resection and irradiation will eventually develop lymphedema [13].…”

Section: Introductionmentioning

confidence: 99%

Effect of home-based exercise program on lymphedema and quality of life in female postmastectomy patients: Pre-post intervention study

Gautam¹,

Maiya²,

Vidyasagar³

2011

JRRD

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Abstract-Lymphedema is a debilitating complication following mastectomy, affecting the arm functions and quality of life (QOL) of breast cancer patients. Studies have shown the beneficial effects of upper-limb exercises on lymphedema in clinical settings. However, there is a dearth of evidence regarding the effect of home-based exercises on lymphedema; therefore, we examined the effect of a home-based exercise program on lymphedema and QOL in postmastectomy patients. Thirty-two female postmastectomy lymphedema patients participated in an individualized home-based exercise program for 8 weeks. Arm circumference, arm volume, and QOL (36-Item Short Form Health Survey) were measured before and after the program. Data were analyzed with the use of paired t-tests for circumferential and volumetric measures and Wilcoxon signed ranks tests for QOL. Significance level was set at p < 0.01 with Bonferroni correction (alpha/n = 0.05/5 = 0.01). Analysis showed a statistically significant improvement in the affected upper-limb circumference and volume (~122 mL reduction, p < 0.001) and in the QOL scores (p < 0.001) at the end of the home-based exercise program. The individualized home-based exercise program led to improvement in affected upper-limb volume and circumference and QOL of postmastectomy lymphedema patients.

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“…It can result in longterm adverse effects that can negatively affect overall quality of life. 1 The pathophysiology involves mechanical insufficiency of the lymphatic vessels because of either obstruction of lymphatic pathways or surgical removal of lymph nodes. In theory, exercise can enhance lymphatic drainage and improve protein resorption, and in a recent randomized controlled trial was proved to be of clinical benefit.…”

Section: Discussionmentioning

confidence: 99%