Incidence and risk factors of upper limb lymphedema in breast cancer patients after surgery

Abstract

Background: Upper limb lymphedema is a common and troublesome complication that follows breast cancer surgery. Aim and Objectives: To find the incidence and identify risk factors for the development of upper limb lymphedema among patients treated for breast cancer. Material and Methods: This was a prospective observational study of 135 patients who underwent different breast cancer surgeries for invasive breast cancer. A description of the patients' demographics and details related to the tumour and axillary clearance were recorded. Using the circumference measurements, lymphoedema was defined as a difference in volume of ≥200 ml between the two arms after six months of surgery. Results: Age, type of surgery (mastectomy versus breast preserving surgery), and adjuvant radiotherapy were not risk factors for lymphedema (p = 0.9977, 0.7794 and 0.852 respectively). A significant correlation was found between BMI above 25 kg/m2, advanced stage, higher number of excised lymph nodes and more than 5 involved lymph nodes, and the development of lymphedema (p =0.0001, 0.002, 0.01 and 0.009 respectively). Positive lymph nodes was a powerful predictor of lymphedema (p = 0.0003). Conclusion: Lymphedema can affect every third patient who is operated on for breast cancer. Advanced stage, increased BMI above 25 kg/m2, increased number of excised lymph node together with increased number of involved lymph nodes, are significant risk factors for breast cancer related lymphedema.

Keywords

• breast cancer lymphedema
• risk factors
• upper limb
• morbidity