Hayes SC, Janda M, Cornish B, Battistutta D, Newman B, et al.
Journal of clinical oncology : official journal of the American Society of Clinical Oncology. Date of publication 2008 Jul 20;volume 26(21):3536-42.
1. J Clin Oncol. 2008 Jul 20;26(21):3536-42. doi: 10.1200/JCO.2007.14.4899.
Lymphedema after breast cancer: incidence, risk factors, and effect on upper body
function.
Hayes SC(1), Janda M, Cornish B, Battistutta D, Newman B.
Author information:
(1)Institute of Health and Biomedical Innovation, School of Public Health,
Queensland University of Technology, Kelvin Grove, Queensland, Australia.
sc.hayes@qut.edu.au
PURPOSE: Secondary lymphedema is associated with adverse physical and
psychosocial consequences among women with breast cancer (BC). This article
describes the prevalence and incidence of lymphedema between 6 and 18 months
after BC treatment; personal, treatment, and behavioral correlates of lymphedema
status; and the presence of other upper-body symptoms (UBS) and function (UBF).
PATIENTS AND METHODS: A population-based sample of Australian women (n = 287)
with recently diagnosed, invasive BC were evaluated on five occasions using
bioimpedance spectroscopy. Lymphedema was diagnosed when the ratio of impedance
values, comparing treated and untreated sides, was three standard deviations more
than normative data. UBF was assessed using the validated Disability of the Arm,
Shoulder, and Hand questionnaire.
RESULTS: From 6 to 18 months after surgery, 33% (n = 62) of the sample were
classified as having lymphedema; of these, 40% had long-term lymphedema. Although
older age, more extensive surgery or axillary node dissection, and experiencing
one or more treatment-related complication(s) or symptom(s) at baseline were
associated with increased odds, lower socioeconomic status, having a partner,
greater child care responsibilities, being treated on the dominant side,
participation in regular activity, and having good UBF were associated with
decreased odds of lymphedema. Not surprisingly, lymphedema leads to reduced UBF;
however, BC survivors report high prevalences of other UBS (34% to 62%),
irrespective of their lymphedema status.
CONCLUSION: Lymphedema is a public health issue deserving greater attention. More
systematic surveillance for earlier detection and the potential benefits of
physical activity to prevent lymphedema and mitigate symptoms warrant further
clinical integration and research.
DOI: 10.1200/JCO.2007.14.4899
PMID: 18640935 [Indexed for MEDLINE]
