Objective To identify the incidence and risk factors for upper extremity lymphedema within 2 years after surgery in patients with breast cancer. Methods A follow-up study was performed among 157 patients who newly received surgical treatment for breast cancer. Norman questionnaire and circumference measurement were used to evaluate the volume of the upper limb before treatment and at 1, 3, 6, 12, 18, and 24 months after treatment. The incidence of lymphedema was calculated. Based on the results of circumference measurement, the log-rank test and Cox regression were used to analyze the risk factors for lymphedema. Results A total of 141 patients were finally enrolled as subjects. The incidence rates of lymphedema at 1, 3, 6, 12, 18, and 24 months after surgery were 3.5%, 9.2%, 13.5%, 24.8%, 28.4%, and 30.5% by Norman questionnaire, and 1.4%, 3.5%, 9.2%, 20.6%, 27.0%, and 27.7% by circumference measurement. At 24 months after surgery, 31(22.0%) out of 39 patients with lymphedema had mild lymphedema. Axillary lymph node dissection (ALND), radiotherapy, modified radical mastectomy (MRM), and the number of removed axillary lymph nodes were independent risk factors for lymphedema (HR=13.58, 95% CI:2.17-85.00;HR=3.54, 95% CI:1.13-11.07;HR=2.19, 95% CI:1.07-4.49;HR=1.11, 95% CI:1.05-1.16). Conclusions The incidence of lymphedema associated with breast cancer increases gradually within 2 years after surgery, especially fast in the first year. ALND, radiotherapy, MRM, and the number of removed axillary lymph nodes are independent risk factors for lymphedema.
Liu Fenghua,Hu Yan,Shen Peipei et al. Lymphedema after surgical treatment for breast cancer:a 2-year follow-up study of incidence and risk factors[J]. Chinese Journal of Radiation Oncology, 2016, 25(6): 593-597.
Liu Fenghua,Hu Yan,Shen Peipei et al. Lymphedema after surgical treatment for breast cancer:a 2-year follow-up study of incidence and risk factors[J]. Chinese Journal of Radiation Oncology, 2016, 25(6): 593-597.
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