title: Lymphoedema after mastectomy for breast cancer: importance of supportive care.
abstract: BACKGROUND
  Lymphoedema resulting from axillary lymph node dissection remains a challenging complication after modified radical mastectomy.
  
  
  OBJECTIVE
  To examine the effects of supportive therapy such as rehabilitation and medical and physical treatment on the development of lymphoedema, in an attempt to establish non-surgical ways to help prevent or reduce it.
  
  
  METHODS
  Patients (N=5 064) who underwent breast cancer surgery in the Department of General Surgery, Ankara Oncology Research and Training Hospital, Turkey, between 1995 and 2010 were included. Data were collected by retrospectively examining all the patients' files and the pre- and postoperative breast cancer follow-up forms.
  
  
  RESULTS
  Of the patients in the study, 19.9% developed lymphoedema. It was significantly less common in patients who participated in physiotherapy than in those who did not, and it was more common in patients with a body mass index (BMI, kg/m²) between 30 and 34.9 than in patients with lower BMIs. Postoperative axillary radiotherapy did not affect the occurrence of lymphoedema.
  
  
  CONCLUSIONS
  It is clear that the most successful method to reduce the impact of lymphoedema is to prevent it. We believe that educating patients about the risk factors for developing lymphoedema and referring them to postoperative physical therapy and rehabilitation clinics are the most important ways to avoid this distressing condition.
authors.affiliation: Department of General Surgery, Kirikkale University School of Medicine, Kirikkale, Turkey. draybala.a.a@gmail.com.
authors.forename: Aybala A
authors.initials: AA
authors.lastname: Ay
authors.forename: Suat
authors.initials: S
authors.lastname: Kutun
authors.forename: Abdullah
authors.initials: A
authors.lastname: Cetin
mesh_terms: D000328:Adult; D000368:Aged; D001132:Arm; D001365:Axilla / Q000601:surgery; D001943:Breast Neoplasms / Q000473:pathology / Q000601:surgery*; D005260:Female; D006801:Humans; D008197:Lymph Node Excision; D008209:Lymphedema / Q000453:epidemiology / Q000209:etiology* / Q000517:prevention & control*; D015411:Mastectomy, Modified Radical; D008875:Middle Aged; D009367:Neoplasm Staging; D026741:Physical Therapy Modalities; D012189:Retrospective Studies; D012307:Risk Factors; D014421:Turkey / Q000453:epidemiology