Prevalence and risk factors for development of lymphedema following breast cancer treatment

S. V.S. Deo, S. Ray, G. K. Rath, N. K. Shukla, M. Kar, S. Asthana, V. Raina

Research output: Contribution to journalArticle

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Abstract

BACKGROUND: Early detection and multimodality therapy has resulted in an overall improvement of survival among breast cancer patients. Despite a significant shift in the treatment approach from radical mastectomy to breast conservation a significant number of patients develop lymphedema. This study was conducted to evaluate the prevalence and risk factors for development of lymphedema. SETTINGS AND DESIGN: Retrospective analysis for prevalence of lymphedema in a tertiary care regional cancer centre. MATERIAL AND METHODS: Three hundred treated breast cancer patients with a minimum follow up of one year were evaluated for the prevalence and risk factors for lymphedema. Lymphedema was assessed using a serial circumferential measurement method. More than 3 cm difference in circumference is considered as clinical significant lymphedema. Univariate and multivariate analysis were performed for evaluating the risk factors by using the Chi square test and Cox logistic regression analysis. RESULTS: The prevalence of clinically significant lymphedema was 33.5 % and 17.2 % had severe lymphedema. The prevalence of lymphedema was 13.4 % in patients treated with surgery only where as the prevalence was 42.4% in patients treated with surgery and radiotherapy. Stage of the disease, body surface area > 1.5 m2, presence of co-morbid conditions, post operative radiotherapy and anthracycline based chemotherapy were significant risk factors in univariate analysis where as axillary irradiation and presence of co-morbid conditions have emerged as independent risk factors in multivariate analysis (P < 0.001). CONCLUSION: Post treatment lymphedema continues to be a significant problem following breast cancer therapy. Presence of co-morbid conditions and axillary radiation significantly increases the risk of lymphedema. A combination of axillary dissection and axillary radiation should be avoided whenever feasible to avoid lymphedema.

Original languageEnglish
Pages (from-to)8-12
Number of pages5
JournalIndian Journal of Cancer
Volume41
Issue number1
Publication statusPublished - 01-01-2004

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Lymphedema
Therapeutics
Breast Neoplasms
Breast Cancer Lymphedema
Radiotherapy
Multivariate Analysis
Radiation
Radical Mastectomy
Body Surface Area
Anthracyclines
Tertiary Healthcare
Chi-Square Distribution
Dissection
Breast
Logistic Models
Regression Analysis

All Science Journal Classification (ASJC) codes

  • Oncology

Cite this

Deo, S. V. S., Ray, S., Rath, G. K., Shukla, N. K., Kar, M., Asthana, S., & Raina, V. (2004). Prevalence and risk factors for development of lymphedema following breast cancer treatment. Indian Journal of Cancer, 41(1), 8-12.
Deo, S. V.S. ; Ray, S. ; Rath, G. K. ; Shukla, N. K. ; Kar, M. ; Asthana, S. ; Raina, V. / Prevalence and risk factors for development of lymphedema following breast cancer treatment. In: Indian Journal of Cancer. 2004 ; Vol. 41, No. 1. pp. 8-12.
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abstract = "BACKGROUND: Early detection and multimodality therapy has resulted in an overall improvement of survival among breast cancer patients. Despite a significant shift in the treatment approach from radical mastectomy to breast conservation a significant number of patients develop lymphedema. This study was conducted to evaluate the prevalence and risk factors for development of lymphedema. SETTINGS AND DESIGN: Retrospective analysis for prevalence of lymphedema in a tertiary care regional cancer centre. MATERIAL AND METHODS: Three hundred treated breast cancer patients with a minimum follow up of one year were evaluated for the prevalence and risk factors for lymphedema. Lymphedema was assessed using a serial circumferential measurement method. More than 3 cm difference in circumference is considered as clinical significant lymphedema. Univariate and multivariate analysis were performed for evaluating the risk factors by using the Chi square test and Cox logistic regression analysis. RESULTS: The prevalence of clinically significant lymphedema was 33.5 {\%} and 17.2 {\%} had severe lymphedema. The prevalence of lymphedema was 13.4 {\%} in patients treated with surgery only where as the prevalence was 42.4{\%} in patients treated with surgery and radiotherapy. Stage of the disease, body surface area > 1.5 m2, presence of co-morbid conditions, post operative radiotherapy and anthracycline based chemotherapy were significant risk factors in univariate analysis where as axillary irradiation and presence of co-morbid conditions have emerged as independent risk factors in multivariate analysis (P < 0.001). CONCLUSION: Post treatment lymphedema continues to be a significant problem following breast cancer therapy. Presence of co-morbid conditions and axillary radiation significantly increases the risk of lymphedema. A combination of axillary dissection and axillary radiation should be avoided whenever feasible to avoid lymphedema.",
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Deo, SVS, Ray, S, Rath, GK, Shukla, NK, Kar, M, Asthana, S & Raina, V 2004, 'Prevalence and risk factors for development of lymphedema following breast cancer treatment', Indian Journal of Cancer, vol. 41, no. 1, pp. 8-12.

Prevalence and risk factors for development of lymphedema following breast cancer treatment. / Deo, S. V.S.; Ray, S.; Rath, G. K.; Shukla, N. K.; Kar, M.; Asthana, S.; Raina, V.

In: Indian Journal of Cancer, Vol. 41, No. 1, 01.01.2004, p. 8-12.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Prevalence and risk factors for development of lymphedema following breast cancer treatment

AU - Deo, S. V.S.

AU - Ray, S.

AU - Rath, G. K.

AU - Shukla, N. K.

AU - Kar, M.

AU - Asthana, S.

AU - Raina, V.

PY - 2004/1/1

Y1 - 2004/1/1

N2 - BACKGROUND: Early detection and multimodality therapy has resulted in an overall improvement of survival among breast cancer patients. Despite a significant shift in the treatment approach from radical mastectomy to breast conservation a significant number of patients develop lymphedema. This study was conducted to evaluate the prevalence and risk factors for development of lymphedema. SETTINGS AND DESIGN: Retrospective analysis for prevalence of lymphedema in a tertiary care regional cancer centre. MATERIAL AND METHODS: Three hundred treated breast cancer patients with a minimum follow up of one year were evaluated for the prevalence and risk factors for lymphedema. Lymphedema was assessed using a serial circumferential measurement method. More than 3 cm difference in circumference is considered as clinical significant lymphedema. Univariate and multivariate analysis were performed for evaluating the risk factors by using the Chi square test and Cox logistic regression analysis. RESULTS: The prevalence of clinically significant lymphedema was 33.5 % and 17.2 % had severe lymphedema. The prevalence of lymphedema was 13.4 % in patients treated with surgery only where as the prevalence was 42.4% in patients treated with surgery and radiotherapy. Stage of the disease, body surface area > 1.5 m2, presence of co-morbid conditions, post operative radiotherapy and anthracycline based chemotherapy were significant risk factors in univariate analysis where as axillary irradiation and presence of co-morbid conditions have emerged as independent risk factors in multivariate analysis (P < 0.001). CONCLUSION: Post treatment lymphedema continues to be a significant problem following breast cancer therapy. Presence of co-morbid conditions and axillary radiation significantly increases the risk of lymphedema. A combination of axillary dissection and axillary radiation should be avoided whenever feasible to avoid lymphedema.

AB - BACKGROUND: Early detection and multimodality therapy has resulted in an overall improvement of survival among breast cancer patients. Despite a significant shift in the treatment approach from radical mastectomy to breast conservation a significant number of patients develop lymphedema. This study was conducted to evaluate the prevalence and risk factors for development of lymphedema. SETTINGS AND DESIGN: Retrospective analysis for prevalence of lymphedema in a tertiary care regional cancer centre. MATERIAL AND METHODS: Three hundred treated breast cancer patients with a minimum follow up of one year were evaluated for the prevalence and risk factors for lymphedema. Lymphedema was assessed using a serial circumferential measurement method. More than 3 cm difference in circumference is considered as clinical significant lymphedema. Univariate and multivariate analysis were performed for evaluating the risk factors by using the Chi square test and Cox logistic regression analysis. RESULTS: The prevalence of clinically significant lymphedema was 33.5 % and 17.2 % had severe lymphedema. The prevalence of lymphedema was 13.4 % in patients treated with surgery only where as the prevalence was 42.4% in patients treated with surgery and radiotherapy. Stage of the disease, body surface area > 1.5 m2, presence of co-morbid conditions, post operative radiotherapy and anthracycline based chemotherapy were significant risk factors in univariate analysis where as axillary irradiation and presence of co-morbid conditions have emerged as independent risk factors in multivariate analysis (P < 0.001). CONCLUSION: Post treatment lymphedema continues to be a significant problem following breast cancer therapy. Presence of co-morbid conditions and axillary radiation significantly increases the risk of lymphedema. A combination of axillary dissection and axillary radiation should be avoided whenever feasible to avoid lymphedema.

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