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. 2016 Feb;11(1):45-50.
doi: 10.1159/000442489. Epub 2015 Dec 14.

Risk Factors for Arm Lymphedema in a Cohort of Breast Cancer Patients Followed up for 10 Years

René Aloisio da Costa Vieira  1 , Allini Mafra da Costa  2 , Josue Lopes de Souza  1 , Rafael Richieri Coelho  3 , Cleyton Zanardo de Oliveira  4 , Almir José Sarri  3 , Renato José Affonso Junior  5 , Gustavo Zucca-Matthes  1
Affiliations

Risk Factors for Arm Lymphedema in a Cohort of Breast Cancer Patients Followed up for 10 Years

René Aloisio da Costa Vieira et al. Breast Care (Basel). 2016 Feb.

Abstract

Background: The etiology of lymphedema is multifactorial, and definition criteria of lymphedema, its limitation, and follow-up must be considered in studies related to risk factors. The aim of this study is to evaluate risk factors related to arm lymphedema in a cohort study with a long follow-up.

Patients and methods: The study was performed in 622 breast cancer patients. The main endpoint reported was the presence of clinical lymphedema reported in medical records. Univariate and multivariate regression analyses were performed to identify factors related to lymphedema.

Results: 66.4% of the patients were submitted to mastectomy, 88.4% to level III axillary lymphadenectomy, 34.9% to radiotherapy in the supraclavicular fossa, and 4.3% to axillary radiotherapy. The mean follow-up was 96.7 months. 45 patients (7.2%) developed lymphedema, of which 82.2% had developed lymphedema at 60 months. Univariate regression analysis showed that supraclavicular radiotherapy, adjuvant/palliative chemotherapy, ≥ 15 lymph nodes dissected, and axillary surgery increase the lymphedema rate by 1.87, 2.28, 2.03, and 6.17, respectively. Adjusted multivariate regression analysis showed that the combination of axillary dissection and number of lymph nodes dissected was the main factor related to lymphedema (p = 0.017).

Conclusion: In the pre-sentinel era, axillary dissection and the number of lymph nodes resected are related to 10-year lymphedema.

Keywords: Breast cancer; Lymph node dissection; Lymphedema; Radiotherapy; Risk factors.

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Figures

Fig. 1
Fig. 1
Kaplan-Meier OS. C = Censure.
Fig. 2
Fig. 2
Lymphedema and survival: (a) OS related to the absence or presence of lymphedema (p = 0.08); (b) cumulative hazard ratio related to the appearance of lymphedema during follow-up. C = Censure.
See this image and copyright information in PMC

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