Time-course of arm lymphedema and potential risk factors for progression of lymphedema after breast conservation treatment for early stage breast cancer

Voichita Bar Ad, Pinaki R. Dutta, Lawrence J. Solin, Wei Ting Hwang, Kay See Tan, Stefan Both, Andrea L Cheville, Eleanor E R Harris

Research output: Contribution to journalArticle

19 Citations (Scopus)

Abstract

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.

Original languageEnglish (US)
Pages (from-to)219-225
Number of pages7
JournalBreast Journal
Volume18
Issue number3
DOIs
StatePublished - May 2012

Fingerprint

Lymphedema
Breast
Arm
Breast Neoplasms
Segmental Mastectomy
Therapeutics
Upper Extremity
Radiotherapy
Lymph Nodes

Keywords

  • arm lymphedema progression
  • breast conservation treatment
  • early stage breast cancer
  • radiation treatment

ASJC Scopus subject areas

  • Internal Medicine
  • Oncology
  • Surgery

Cite this

Time-course of arm lymphedema and potential risk factors for progression of lymphedema after breast conservation treatment for early stage breast cancer. / Bar Ad, Voichita; Dutta, Pinaki R.; Solin, Lawrence J.; Hwang, Wei Ting; Tan, Kay See; Both, Stefan; Cheville, Andrea L; Harris, Eleanor E R.

In: Breast Journal, Vol. 18, No. 3, 05.2012, p. 219-225.

Research output: Contribution to journalArticle

Bar Ad, Voichita ; Dutta, Pinaki R. ; Solin, Lawrence J. ; Hwang, Wei Ting ; Tan, Kay See ; Both, Stefan ; Cheville, Andrea L ; Harris, Eleanor E R. / Time-course of arm lymphedema and potential risk factors for progression of lymphedema after breast conservation treatment for early stage breast cancer. In: Breast Journal. 2012 ; Vol. 18, No. 3. pp. 219-225.
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abstract = "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.",
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