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. 2019 Mar 7;14(1):39.
doi: 10.1186/s13014-019-1243-y.

Frequency and risk factors for arm lymphedema after multimodal breast-conserving treatment of nodal positive breast Cancer - a long-term observation

Julia Rupp  1   2 , Catarina Hadamitzky  3   4 , Christoph Henkenberens  1 , Hans Christiansen  1 , Diana Steinmann  1 , Frank Bruns  5
Affiliations

Frequency and risk factors for arm lymphedema after multimodal breast-conserving treatment of nodal positive breast Cancer - a long-term observation

Julia Rupp et al. Radiat Oncol. .

Abstract

Background: Arm-lymphedema is a major complication after breast cancer. Recent studies demonstrate the validity of predicting Breast Cancer Related Lymphedema (BCRL) by self-reports. We aimed to investigate the rate of BCRL and its risk factors in the long-term using self-reported symptoms.

Methods: Data was collected from 385 patients who underwent multimodal therapy for nodal positive breast cancer, including breast conserving surgery, axillary dissection, and local or locoregional radiotherapy. Two validated questionnaires were used for the survey of BCRL (i.e. LBCQ-D and SDBC-D). These were analysed collectively with retrospective data of our medical records.

Results: 23.5% (n = 43) suffered a permanent BCRL (stage II-III) after a median follow-up time of 10.1 years (4.9-15.9 years); further 11.5% (n = 23) reported at least one episode of reversible BCRL (Stage 0-I) during the follow-up time. 87.1% of the patients with lymphedema developed this condition in the first two years. Adjuvant chemotherapy was a significant risk factor for the appearance of BCRL (p = 0.001; 95%-CI 7.7-10.2).

Conclusions: Breast cancer survivors face a high risk of BCRL, particularly if axillary dissection was carried out. Almost 90% of BCRL occurred during the first two years after radiotherapy. Self-report of symptoms seems to be a suitable instrument of early detection of BCRL.

Keywords: Axillary surgery; BCRL; Breast cancer; Breast-conserving surgery; Lymphedema; Quality of life; Radiotherapy.

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Conflict of interest statement

Ethics approval and consent to participate

This investigation (including the survey) was performed with the approval of the regional Hannover Medical School ethics committee (No 2065–2013). This article does not contain any studies with human subjects. The research described in the present manuscript was in accordance with both national law and the Helsinki Declaration of 1975 (including its most recently amended version). Informed consent was obtained from all individual participants included in the study.

Consent for publication

Not applicable.

Competing interests

The authors declare that they have no competing interests.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Figures

Fig. 1
Fig. 1
Correlation between the occurrence of lymphedema and adjuvant chemotherapy
See this image and copyright information in PMC

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