Time course of mild arm lymphedema after breast conservation treatment for early-stage breast cancer.
OBJECTIVE
Arm lymphedema is a potential consequence of the treatment for breast carcinoma. The objective of this retrospective study was to characterize the progression of mild arm lymphedema after breast conservation treatment for breast cancer.


METHODS
The study cohort was drawn from 1,713 consecutive Stage I or II breast cancer patients who underwent breast conservation therapy, including axillary staging followed by radiation. Arm lymphedema was documented in 266 (16%) of 1,713 patients. One hundred nine patients, 6% of the overall group and 40% of the patients with arm lymphedema, presented with mild arm lymphedema, defined as a difference of 2 cm or less between the measured circumferences of the affected and unaffected arms.


RESULTS
Among the 109 patients with mild arm lymphedema at the time of arm lymphedema diagnosis, the rate of freedom from progression to more severe lymphedema was 79% at 1 year, 66% at 3 years, and 52% at 5 years. The patients who were morbidly obese, had positive axillary lymph nodes, or received supraclavicular irradiation at the time of breast cancer treatment were at higher risk of progression from mild arm lymphedema to more severe edema.


CONCLUSIONS
Mild arm lymphedema, generally considered to be a minor complication after breast conservation treatment for breast cancer, was associated with a risk of progression to a more severe grade of arm lymphedema in a substantial fraction of patients.
Department of Radiation Oncology, University of Pennsylvania, Philadelphia, PA 19104, USA. barad@xrt.upenn.edu
Voichita
V
Bar Ad
Andrea
A
Cheville
Lawrence J
LJ
Solin
Pinaki
P
Dutta
Stefan
S
Both
Eleanor E R
EE
Harris
D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D001132:Arm; D001365:Axilla; D001943:Breast Neoplasms / Q000473:pathology / Q000628:therapy*; D018450:Disease Progression; D055088:Early Detection of Cancer; D005260:Female; D006801:Humans; D008197:Lymph Node Excision / Q000009:adverse effects; D015182:Lymphatic Irradiation / Q000379:methods; D008207:Lymphatic Metastasis / Q000473:pathology; D008209:Lymphedema / Q000209:etiology / Q000473:pathology*; D008875:Middle Aged; D009367:Neoplasm Staging; D016016:Proportional Hazards Models; D011879:Radiotherapy Dosage; D012189:Retrospective Studies; D021701:Sentinel Lymph Node Biopsy / Q000706:statistics & numerical data