title: [Upper limb lymphedema after breast cancer treatment].
abstract: OBJECTIVE
  To study the frequency and risk factors for upper limb lymphedema through a series of patients treated for breast cancer.
  
  
  METHODS
  It is a retrospective study about 222 patients treated for breast cancer during the period between February 1993 and December 2003 in Sfax hospitals. Average age was 51 years (27-92 years). Tumour was T2 in 59% of cases. All patients had surgery with lymph node dissection. Infiltrating ductal carcinoma was the most frequent histological type (80% of cases), with predominant SBR II grade (62%). The mean number of removed lymph nodes was 12 (2-33). Axillary lymph node metastasis was detected in 124 patients. Radiotherapy was delivered in 200 patients, including axillary irradiation in 30 cases. The mean follow-up was 68 months (12-120).
  
  
  RESULTS
  Lymphedema appeared in 23% of cases (51 patients), 14 months after surgery (mean period). Lymphedema affected the brachium in 17% of cases, the forearm in 12% of cases and all upper limb in 71% of cases. Fifty percent of patients had rehabilitation. However, improvement of lymphedema was obtained in 18 cases. Parameters predicting lymphedema were studied. Significant risk factors were obesity, infection and a number of removed lymph node above 10. The type of surgery, axillary irradiation and shoulder abduction deficit did not predict lymphedema.
  
  
  CONCLUSIONS
  Lymphedema of the arm is a frequent consequence of breast cancer treatment. The risk of lymphedema is correlated with obesity, infection and a number of removed lymph node above 10.
authors.affiliation: Service de radiothérapie carcinologique, CHU Habib-Bourguiba, Sfax, Tunisie. ben_salah_hanen@yahoo.fr
authors.forename: H
authors.initials: H
authors.lastname: Ben Salah
authors.forename: M
authors.initials: M
authors.lastname: Bahri
authors.forename: B
authors.initials: B
authors.lastname: Jbali
authors.forename: M
authors.initials: M
authors.lastname: Guermazi
authors.forename: M
authors.initials: M
authors.lastname: Frikha
authors.forename: J
authors.initials: J
authors.lastname: Daoud
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001132:Arm; D001943:Breast Neoplasms / Q000628:therapy*; D005260:Female; D006801:Humans; D008209:Lymphedema / Q000453:epidemiology*; D008875:Middle Aged; D012189:Retrospective Studies