Lymphedema and quality of life in survivors of early-stage breast cancer.
BACKGROUND
The standard of care for early-stage breast cancer includes surgical removal of the tumor and axillary lymph node dissection (ALND). Despite increased use of breast-conserving surgery, lymphedema rates are similar to those with more radical surgery.


OBJECTIVE
Women who experience breast cancer-related lymphedema have a measurable reduction in quality of life compared with women without lymphedema.


METHODS
In a retrospective cohort study, we explored the association between lymphedema and quality of life, controlling for patient demographics, surgical factors, and treatment types.


METHODS
An urban academic medical center and a community hospital.


METHODS
A total of 151 women surgically treated for early-stage breast cancer (stages 0-II) were assessed at least 1 year after their ALND. The women had been treated with either conservative surgery and radiation or mastectomy without radiation.


METHODS
Arm volume was measured by water displacement. Grip strength and range-of-motion measurements assessed arm function. The Functional Assessment of Cancer Therapy-Breast (FACT-B) quality-of-life instrument assessed breast, emotional, functional, physical, and social well-being.


RESULTS
Lymphedema (an arm volume difference > or =200 cm(3)) was measured in 42 women (27.8%). Mastectomy or conservative surgery patients had similar lymphedema rates. Women with lymphedema in both surgical groups scored significantly lower on 4 of the 5 subsections than women without lymphedema, even after adjusting for other factors influencing quality of life.


CONCLUSIONS
Lymphedema occurs at appreciable rates, and its impact on long-term quality of life in survivors of early-stage breast cancer should not be underestimated.
Beaulac
Sarah M
SM
Department of Epidemiology, Boston University Medical Center, Mass, USA.
McNair
Lindsay A
LA
Scott
Thayer E
TE
LaMorte
Wayne W
WW
Kavanah
Maureen T
MT
D000368:Aged; D001132:Arm; D001365:Axilla; D001837:Body Weights and Measures; D001943:Breast Neoplasms / Q000473:pathology / Q000601:surgery* / Q000628:therapy; D015331:Cohort Studies; D005260:Female; D006801:Humans; D008197:Lymph Node Excision / Q000009:adverse effects*; D008209:Lymphedema / Q000175:diagnosis / Q000209:etiology*; D008408:Mastectomy; D008875:Middle Aged; D009367:Neoplasm Staging; D011788:Quality of Life; D011878:Radiotherapy; D012189:Retrospective Studies; D017741:Survivors