Time Course of Mild Arm Lymphedema After Breast Conservation Treatment for Early-Stage Breast Cancer

Ad, Voichita Bar; Cheville, Andrea L.; Solin, Lawrence J.; Dutta, Pinaki; Both, Stefan; Harris, Eleanor

doi:10.1016/j.ijrobp.2009.01.024

Cited by 62 publications

(48 citation statements)

References 34 publications

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“…Patient-related factors—such as obesity, hand use, injury, and infection—could be modified to reduce the risk for these patients [1]. In a study of 109 patients with mild LE at LE diagnosis by Bar Ad et al [19], 52 (48%) progressed to more severe stages at some point during the first 5 years of follow-up. In our study, 49 of 351 patients (14%) initially diagnosed as grade 1 eventually progressed to grade 2, with one patient progressing to grade 3.…”

Section: Discussionmentioning

confidence: 99%

Identification of Prognostic Risk Factors for Transient and Persistent Lymphedema after Multimodal Treatment for Breast Cancer

et al. 2016

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PurposeThe purpose of this study is to identify risk factors for transient lymphedema (TLE) and persistent lymphedema (PLE) following treatment for breast cancer.Materials and MethodsA total of 1,073 patients who underwent curative breast surgery were analyzed. TLE was defined as one episode of arm swelling that had resolved spontaneously by the next follow-up; arm swelling that persisted over two consecutive examinations was considered PLE.ResultsAt a median follow-up period of 5.1 years, 370 cases of lymphedema were reported, including 120 TLE (11.2%) and 250 PLE (23.3%). Initial grade 1 swelling was observed in 351 patients, of which 120 were limited to TLE (34%), while the other 231 progressed to PLE (66%). All initial swelling observed in TLE patients was classified as grade 1. In multivariate analysis, chemotherapy with taxane and supraclavicular radiation therapy (SCRT) were associated with development of TLE, whereas SCRT, stage III cancer and chemotherapy with taxane were identified as risk factors for PLE (p < 0.05). The estimated incidence of TLE among initial grade 1 patients was calculated using up to three treatment-related risk factors (number of dissected axillary lymph nodes, SCRT, and taxane chemotherapy). The approximate ratios of TLE and PLE based on the number of risk factors were 7:1 (no factor), 1:1 (one factor), 1:2 (two factors), and 1:3 (three factors).ConclusionOne-third of initial swelling events were transient, whereas the other two-thirds of patients experienced PLE. Estimation of TLE and PLE based on known treatment factors could facilitate prediction of this life-long complication.

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Section: Discussionmentioning

confidence: 99%

Identification of Prognostic Risk Factors for Transient and Persistent Lymphedema after Multimodal Treatment for Breast Cancer

et al. 2016

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“…One reason for this difference may be that women in the present study and the other Swedish study [4] had in many cases begun their lymphoedema treatment early, at less than 10 % difference in lymphoedema volume. Bar Ad et al [22] showed that 48 % of the women with mild arm lymphoedema had progression at some point during the first 5 years. Among these 48 % whose arm lymphoedema progressed, 47 % reverted to mild lymphoedema at some point [22].…”

Section: Discussionmentioning

confidence: 99%

“…Bar Ad et al [22] showed that 48 % of the women with mild arm lymphoedema had progression at some point during the first 5 years. Among these 48 % whose arm lymphoedema progressed, 47 % reverted to mild lymphoedema at some point [22]. Stout-Gergerich et al [11] showed that early treatment with compression decreased lymphoedema.…”

Section: Discussionmentioning

confidence: 99%

Lymphoedema and health-related quality of life by early treatment in long-term survivors of breast cancer. A comparative retrospective study up to 15 years after diagnosis

Karlsson

Wallenius

Nilsson‐Wikmar

et al. 2015

Support Care Cancer

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“…[17,18] In particular, lymphedema influences the morbidity of cancer survivors because it is a chronic, progressive and incurable disease. [19,20] The incidence of lymphedema has been reported to be 6-70%.…”

Section: Discussionmentioning

confidence: 99%

Optimal pressure for measuring objective lymphedema with postoperative ultrasonography in patients with breast cancer

Lim

Hwang

Park

et al. 2016

Computer Assisted Surgery

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Objective: To examine the reliability of ultrasonographic thickness and compressibility along with real-time pressure monitoring to evaluate postmastectomy lymphedema and to suggest a reference range of appropriate pressure. Design: Measurement reliability study. Setting: Research laboratory. Participants: Fifteen patients with prior mastectomy for breast cancer who were diagnosed with secondary lymphedema, and 16 healthy control subjects. Methods: The thickness and compressibility of the subcutaneous layer in the arms of 15 postmastectomy patients with secondary lymphedema were measured using B-mode and M-mode ultrasonography. An ultrasound machine was equipped with a real-time pressure-monitoring device to monitor downward compression pressure on the arms at a constant velocity. The ratio of thickness change defined the compressibility index. Two different experienced examiners participated in the measurement of lymphedema. Intrarater reliability and inter-rater reliability were estimated using the intraclass correlation coefficient. Very good reliability was defined as an ICC of more than 0.8. Main outcome measurements: The thickness of the subcutaneous layer, the compressibility index, and the intrarater and inter-rater reliability were measured.Results: The measured thicknesses demonstrated very good intrarater and inter-rater reliability for the forearm and upper arm. For the compressibility index, the upper arm and forearm had very good intrarater and inter-rater reliability at over 2000 Pa of compression (>0.9). Conclusions: Ultrasonography with real-time pressure monitoring may be useful for evaluating the severity and characteristics of lymphedema, particularly at compression pressures more than 2000 Pa.

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Time Course of Mild Arm Lymphedema After Breast Conservation Treatment for Early-Stage Breast Cancer

Cited by 62 publications

References 34 publications

Identification of Prognostic Risk Factors for Transient and Persistent Lymphedema after Multimodal Treatment for Breast Cancer

Identification of Prognostic Risk Factors for Transient and Persistent Lymphedema after Multimodal Treatment for Breast Cancer

Lymphoedema and health-related quality of life by early treatment in long-term survivors of breast cancer. A comparative retrospective study up to 15 years after diagnosis

Optimal pressure for measuring objective lymphedema with postoperative ultrasonography in patients with breast cancer

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