Upper limb lymphedema after breast cancer treatment

作者：Ben Salah H^*; Bahri M; Jbali B; Guermazi M; Frikha M; Daoud J

来源：Cancer Radiotherapie, 2012, 16(2): 123-127.

DOI：10.1016/j.canrad.2011.10.011

• Lymphedema
• Secondary
• Breast cancer
• Risk factor

Purpose. - To study the frequency and risk factors for upper limb lymphedema through a series of patients treated for breast cancer.
Patients and methods. - It is a retrospective study about 222 patients treated for breast cancer during the period between February 1993 and December 2003 in Sfax hospitals. Average age was 51 years (27-92 years). Tumour was T2 in 59% of cases. All patients had surgery with lymph node dissection. Infiltrating ductal carcinoma was the most frequent histological type (80% of cases), with predominant SBR II grade (62%). The mean number of removed lymph nodes was 12 (2-33). Axillary lymph node metastasis was detected in 124 patients. Radiotherapy was delivered in 200 patients, including axillary irradiation in 30 cases. The mean follow-up was 68 months (12-120).
Results. - Lymphedema appeared in 23% of cases (51 patients), 14 months after surgery (mean period). Lymphedema affected the brachium in 17% of cases, the forearm in 12% of cases and all upper limb in 71% of cases. Fifty percent of patients had rehabilitation. However, improvement of lymphedema was obtained in 18 cases. Parameters predicting lymphedema were studied. Significant risk factors were obesity, infection and a number of removed lymph node above 10. The type of surgery, axillary irradiation and shoulder abduction deficit did not predict lymphedema.
Conclusion. - Lymphedema of the arm is a frequent consequence of breast cancer treatment. The risk of lymphedema is correlated with obesity, infection and a number of removed lymph node above 10.

• 出版日期2012-4