Early-stage breast cancer: arm edema after wide excision and breast irradiation.
OBJECTIVE
To determine the incidence of arm edema in women with early-stage breast cancer after breast-conserving surgery and irradiation.


METHODS
Women aged 29-83 years (mean, 55.9 years) treated with breast-conserving surgery and irradiation (n = 183) underwent a series of measurements of the circumference of each arm. Patient and treatment factors were analyzed for predictive value.


RESULTS
Arm edema developed in 35.0% (n = 64), and clinically significant edema developed in 17.5% (n = 32) of patients. Dissections that yielded 16 or more nodes led to a 44% actuarial incidence of edema and a 29% actuarial incidence of clinically significant edema. Clinically significant arm changes occurred in 19 of the 87 (22%) women older than 55 years and in 13 of the 96 (14%) women younger than 55 years (P = .002). Chemotherapy, breast radiation dose, and use of tamoxifen had no effect on development of edema.


CONCLUSIONS
Axillary dissection producing more than 15 nodes and age older than 55 years are predictive of arm edema.
Kiel
K D
KD
Department of Radiation Oncology, Northwestern Memorial Hospital, Chicago, IL, USA.
Rademacker
A W
AW
D000206:Actuarial Analysis; D000328:Adult; D000368:Aged; D001132:Arm; D001943:Breast Neoplasms / Q000532:radiotherapy* / Q000601:surgery; D003131:Combined Modality Therapy; D004487:Edema / Q000209:etiology*; D005260:Female; D006801:Humans; D008197:Lymph Node Excision / Q000009:adverse effects; D015412:Mastectomy, Segmental; D008875:Middle Aged; D011878:Radiotherapy / Q000009:adverse effects; D011879:Radiotherapy Dosage; D012307:Risk Factors