Bar Ad V, Dutta PR, Solin LJ, Hwang WT, Tan KS, Both S, Cheville A, Harris EE, et al.
The breast journal. Date of publication 2012 May 1;volume 18(3):219-25.
1. Breast J. 2012 May-Jun;18(3):219-25. doi: 10.1111/j.1524-4741.2012.01229.x. Epub
2012 Apr 5.
Time-course of arm lymphedema and potential risk factors for progression of
lymphedema after breast conservation treatment for early stage breast cancer.
Bar Ad V(1), Dutta PR, Solin LJ, Hwang WT, Tan KS, Both S, Cheville A, Harris EE.
Author information:
(1)Department of Radiation Oncology, University of Pennsylvania, 111 S.11th
Street, Philadelphia, PA 19107, USA. voichita.bar-ad@jeffersonhospital.org
The objective of this study was to describe the progression of arm lymphedema
(ALE) after the initial presentation among patients receiving breast conservation
therapy for early stage breast cancer and to identify potential risk factors
contributing to ALE progression. The study sample was the 266 stage I or II
breast cancer patients with documented ALE who underwent breast conservation
therapy that included lumpectomy, axillary staging followed by radiation therapy.
ALE were graded according to a difference of 0.5-2 cm (mild), 2.1-3 cm
(moderate), and >3 cm (severe) in the circumference between the upper extremities
for the treated and untreated sides. ALE at presentation was scored as mild,
moderate, and severe in 109 (41%), 125 (47%), and 32 (12%) patients,
respectively. One third of patients with ALE progressed to a more severe grade of
lymphedema at 5 years of follow-up. Age older than 65 years at the time of breast
cancer treatment was associated with higher risk of ALE progression when compared
65 year age or younger (p = 0.04). The patients who had regional lymph node
irradiation including posterior axillary boost were at higher risk of lymphedema
progression than the patients treated with whole breast irradiation only
(p = 0.001). Progression of ALE is a common occurrence. The current study
provides support for the utility of routine arm measurements after breast cancer
treatment to facilitate timely diagnosis and treatment of ALE.
© 2012 Wiley Periodicals, Inc.
DOI: 10.1111/j.1524-4741.2012.01229.x
PMID: 22487094 [Indexed for MEDLINE]
