Early arm swelling after breast surgery: changes on both sides.
BACKGROUND
Lymphedema is a common complication of treatment for breast cancer. However, little information is available describing changes in upper limb volumes in the early stages following surgery.


METHODS



METHODS
Retrospective audit.


METHODS
Women who underwent unilateral mastectomy or axillary node removal for breast cancer at the Princess Alexandra Hospital, Brisbane, Australia.


METHODS
Circumferential measurements taken at 10 cm intervals from the ulnar styloid on each arm were converted to segmental volumes using the frustum approach.


METHODS
Pre-surgery baseline measures were taken by a physiotherapist at Preadmission Clinic at the Princess Alexandra Hospital. Follow-up measures were taken 6 weeks after surgery by Domiciliary Allied Health Acute Care and Rehabilitation Service physiotherapists in patients' homes.


RESULTS
Limb segment volumes increased in the proximal upper limb segments at follow-up. The proportion of patients with a 10% or greater increase in volume in one or more segments of their upper limb were similar for ipsilateral (35%) and contralateral (32%) sides (to side of surgery), respectively. No significant interaction between time and arm (ipsilateral versus contralateral) was identified.


CONCLUSIONS
These findings demonstrate that limb segment volume changes affect a greater proportion of patients during the first 6 weeks following surgery than previously recorded. They also indicate that flow of lymph from the side of surgery to the contralateral side may disperse lymph between sides during this early post-operative period. This has implications for how swelling is measured during this period and strategies to prevent onset of lymphedema.
Haines
Terry P
TP
The University of Queensland, Brisbane, Australia. Terrence_Haines@health.qld.gov.au
Sinnamon
Patricia
P
D000368:Aged; D001132:Arm / Q000473:pathology*; D001315:Australia; D001943:Breast Neoplasms / Q000601:surgery*; D005260:Female; D006801:Humans; D008197:Lymph Node Excision; D008209:Lymphedema / Q000209:etiology / Q000517:prevention & control; D008408:Mastectomy / Q000009:adverse effects; D008875:Middle Aged; D012189:Retrospective Studies; D012307:Risk Factors; D013997:Time Factors