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Breast Cancer Res Treat (2012) 134:915922 DOI 10.1007/s10549-012-2004-x
REVIEW
A prospective study of breast lymphedema: frequency, symptoms, and quality of life
Amy C. Degnim Joyce Miller Tanya L. Hoskin
Judy C. Boughey Margie Loprinzi Kristine Thomsen
Shaun Maloney Larry M. Baddour Andrea L. Cheville
Received: 26 January 2012 / Accepted: 21 February 2012 / Published online: 14 March 2012 Springer Science+Business Media, LLC. 2012
Abstract Although lymphedema of the arm is a well-known complication of breast and axillary surgery, breast lymphedema has received scant attention. We sought to prospectively characterize breast lymphedemas incidence, associated symptoms, clinical course, and impact on quality of life. Subjects were enrolled prospectively from a consecutive sample of patients undergoing non-mastectomy breast procedures (excisional biopsy or wide local excision lymph node removal) and followed for signs and symptoms of lymphedema in the operated breast. Symptoms and distress were serially assessed with 11-point linear analog scales. Breast lymphedema was diagnosed independent of symptoms, based on the distribution and degree of edema and erythema. One hundred twenty-four women were followed for a median of 11 months, and breast lymphedema was diagnosed in 38 (31%) women. Breast lymphedema was more frequent after breast surgery with axillary node removal (49%) compared to breast surgery alone (0%), p \ 0.0001. Breast lymphedema involved multiple quadrants in most women and was
characterized by edema in 100% and erythema in 79%. Patients with breast lymphedema were signicantly more likely than women without breast lymphedema to report symptoms of breast heaviness (65% vs 22%, p \ 0.0001), redness (62% vs 29%, p = 0.0006), and swelling (59% vs 22%, p \ 0.0001), but symptom-associated distress was low overall. Three of 32 breast lymphedema patients with clinical follow-up developed chronic edema. Breast lymphedema occurs in approximately one-half of women who undergo breast surgery with axillary node removal. The condition is characterized by diffuse skin edema and erythema as well as self-reported symptoms with a low level of distress.
Keywords Breast lymphedema Quality of life
Breast edema Symptom
Introduction
Arm lymphedema is a well-known complication of breast cancer treatment [1], but lymphedema can also involve the breast [2, 3]. The associated erythema and edema of breast lymphedema may raise concerns for infection or inammatory cancer, leading to prolonged antibiotics or overly...