Lymphedema of the Arm After Treatment of Breast Cancer

Schünemann, H.; Willich, N.

doi:10.1007/978-3-642-46794-3_14

Cited by 20 publications

(29 citation statements)

References 16 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Based on the available literature and results of the current study a combination of surgery and axillary radiotherapy seems to be acting in synergistic fashion in the causation of lymphedema, resulting in 3 to 7 folds increase of lymphedema incidence. [11,25] In summary, the current study showed a correlation between increased lymphedema rates and younger age, hypertension, increased BMI, higher stage, lymph node status and axillary irradiation. BMI, lymph node status, higher stage and axillary radiotherapy were the independent predictors of upper extremity lymphedema.…”

Section: Observations and Resultssupporting

confidence: 51%

Risk Factors for Development of Lymphedema Following Breast Cancer Treatment : A Retrospective Study

Madhusudan¹,

K²,

Sunil³

et al. 2015

jemds

View full text Add to dashboard Cite

OBJECTIVES:The aim and objective of this study is to identify the factors associated with secondary lymphedema after breast cancer treatment. BACKGROUND: Lymphedema of the arm is a complication of breast cancer treatment that affects 2-40% of breast cancer survivors. The pathophysiology of lymphedema following breast cancer treatment is poorly understood, probably suggesting a multifactor nature. As the breast cancer survival rate increases, lymphedema will potentially impact more women. METHODS: A retrospective study of 506 patients who underwent modified radical mastectomy for breast cancer in our institute between January 2009 to December 2013. Available follow up period varied from 8 months to 5 years. RESULTS: Out of 506 patients studied 70 patients developed lymphedema. Lymphedema was associated with younger age group at diagnosis, positive history of hypertension, obesity, Involvement of more than 4 lymph nodes, higher TNM stage, and axillary RT. CONCLUSION: Post treatment lymphedema continues to be a significant problem following breast cancer therapy. Combination of axillary dissection and axillary radiotherapy should be avoided whenever feasible to avoid lymphedema. Control of hypertension and weight reduction via dietary and exercise interventions may be most effective preventive and therapeutic measures.

show abstract

Section: Observations and Resultssupporting

confidence: 51%

Risk Factors for Development of Lymphedema Following Breast Cancer Treatment : A Retrospective Study

Madhusudan¹,

K²,

Sunil³

et al. 2015

jemds

View full text Add to dashboard Cite

show abstract

“…With a high rate of 49%-63% reported during the era of radical mastectomy [26,27], the incidence of lymphedema has shown a decreasing trend following introduction and wide spread adaptation of technique of modified radical mastectomy [28,29]. Simple mastectomy without axillary dissection carried an incidence of 9.1% of lymphedema compared to 31.5% in patients following modified radical mastectomy in a report by Say et al [30].…”

Section: Discussionmentioning

confidence: 99%

“…However some authors have noted that that the extent or level of axillary node dissection does not show statistically significant association with the risk of development of lymphedema [18,31]. Postoperative radiotherapy (and its sequelae) increase the risk of and aggravate lymphedema [13,28,29] although not all will agree [12]. 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].…”

Section: Discussionmentioning

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

View full text Add to dashboard Cite

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.

show abstract

“…Detection of lymphoedema is given central importance in the NICE guidelines, although its symptoms do not correlate with objective measurements of arm swelling (Schunemann and Willich, 1998). Moreover, there is little in the way of an effective therapy.…”

Section: Discussionmentioning

confidence: 99%

Changing pattern of the detection of locoregional relapse in breast cancer: the Edinburgh experience

et al. 2007

View full text Add to dashboard Cite

The guidelines for follow-up of breast cancer patients concentrate on the first 3 -5 years, with either reduced frequency of visits or discharge after this. They also recommend mammography, but no evidence exists to inform frequency. We analyse treatable relapses in our unit from 1312 patients with early stage breast cancer treated by breast conserving surgery (BCS) and postoperative radiotherapy between 1991 and 1998 to assess appropriateness of the guidelines. A total of 110 treatable relapses were analysed. Treatable relapse developed at 1 -1.5% per year throughout follow-up. Forty-eight relapses were in ipsilateral breast, 25 ipsilateral axilla, 35 contralateral breast, 2 both breasts simultaneously. Thirty-seven relapses (33.5%) were symptomatic, 56 (51%) mammographically detected, 15 (13.5%) clinically detected, 2 (2%) diagnosed incidentally. Mammography detected 5.37 relapses per 1000 mammograms. Patients with symptomatic or mammographically detected ipsilateral breast relapse had significantly longer survival from original diagnosis (P ¼ 0.0002) and from recurrence (P ¼ 0.0014) compared with clinically detected. Treatable relapse occurs at a constant rate for at least 10 years. Clinical examination detects a minority (13.5%). Relapse diagnosed clinically is associated with poorer outcome. Long-term follow-up based on regular mammography is warranted for all patients treated by BCS.

show abstract

Lymphedema of the Arm After Treatment of Breast Cancer

Cited by 20 publications

References 16 publications

Risk Factors for Development of Lymphedema Following Breast Cancer Treatment : A Retrospective Study

Risk Factors for Development of Lymphedema Following Breast Cancer Treatment : A Retrospective Study

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

Changing pattern of the detection of locoregional relapse in breast cancer: the Edinburgh experience

Contact Info

Product

Resources

About