title: Lymphedema secondary to postmastectomy radiation: incidence and risk factors.
abstract: BACKGROUND
  Postmastectomy radiotherapy (PMRT) has proven benefits for certain patients with breast cancer; however, one of its complications is lymphedema. This study examines the incidence of and risk factors associated with lymphedema secondary to PMRT.
  
  
  METHODS
  The charts of patients treated with mastectomy at Roswell Park Cancer Institute between January 1, 1995, and April 20, 2001, who received PMRT were reviewed. Univariate analysis of patient, disease, and treatment variables was conducted. Multivariate analysis was performed on variables found to be significant in univariate analysis.
  
  
  RESULTS
  One hundred five patients received PMRT. The incidence of lymphedema was 27%. Patient age, body mass index, disease stage, positive lymph nodes, nodes resected, postoperative infection, duration of drainage, chemotherapy, and hormonal therapy were not associated with lymphedema. Total dose (P =.032), posterior axillary boost (P =.047), overlap technique (P =.037), radiotherapy before 1999 (P =.028), and radiotherapy at Roswell Park Cancer Institute (P =.028) were significantly associated with lymphedema. Increased lymphedema was noted with supraclavicular, internal mammary, mastectomy scar boost, and chest wall tangential photon beam radiation, but the associations were not statistically significant.
  
  
  CONCLUSIONS
  The high incidence and debilitating effects of lymphedema must be weighed against the benefits of PMRT. Efforts to prevent lymphedema should be emphasized.
authors.affiliation: Roswell Park Cancer Institute, Department of Surgical Oncology, Elm and Carlton Streets, Buffalo, NY 14263, USA.
authors.forename: Christian S
authors.initials: CS
authors.lastname: Hinrichs
authors.forename: Nancy L
authors.initials: NL
authors.lastname: Watroba
authors.forename: Hamed
authors.initials: H
authors.lastname: Rezaishiraz
authors.forename: William
authors.initials: W
authors.lastname: Giese
authors.forename: Thelma
authors.initials: T
authors.lastname: Hurd
authors.forename: Kathleen A
authors.initials: KA
authors.lastname: Fassl
authors.forename: Stephen B
authors.initials: SB
authors.lastname: Edge
mesh_terms: D001943:Breast Neoplasms / Q000532:radiotherapy* / Q000601:surgery; D005260:Female; D006801:Humans; D015994:Incidence; D008209:Lymphedema / Q000453:epidemiology* / Q000209:etiology; D008875:Middle Aged; D015999:Multivariate Analysis; D009518:New York / Q000453:epidemiology; D018714:Radiotherapy, Adjuvant / Q000009:adverse effects; D012189:Retrospective Studies; D012307:Risk Factors