This study examines the progression of arm lymphoedema (ALE) in patients treated with breast conserving surgery (BCS) for early stage breast cancer, and aimed to identify potential risk factors for progression of ALE. The study sample consisted of 266 patients (stage I and II) who received BCS and Axillary nodal dissection followed by radiotherapy. Lymphoedema was classed into mild, moderate, or severe category according to the differences in arm circumference between the treated and untreated sides; 0.5-2cm (mild), 2.1-3cm (moderate), and >3cm (severe) respectively. On initial presentation 41% had mild, 47% had moderate, and 12% had severe lymphoedema. However, after median follow-up of 56 months, 34% of the cohort had upgraded to a more severe grade of lymphoedema. Univariate and multivariate analysis showed that risk factors for progression included age older than 65 years old at presentation (p=0.04) and regional lymph node irradiation (p=0.001). Progression was not influenced by BMI, number of lymph nodes removed, or time from treatment of breast cancer to the development of initial lymphoedema.
The Breast Journal 2012; DOI; 10.1111/j.1524-4741.2012.01229.x
Headline: Progression of arm lymphodema is a common occurrence following breast conserving surgery
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