LYMPHEDEMA AFTER MODIFIED RADICAL MASTECTOMY FOR THE BREAST CANCER: INCIDENCE AND RISK FACTORS

BACKGROUND: Lymphedema of the upper limb following breast cancer treatment has severe psycological and physical morbidity. The objective of the current study is to estimate the incidence and the risk factors of arm lymphedema in patients with invasive breast cancer treated with modified radical mastectomy. METHODS: The features of the cases treated with modified radical mastectomy (MRM) between 1999-2003 in our clinic were evaluated in this retrospective study. The effects of the T stage of the primary tumor, axillary nodal invasion, the tumor's stage, radiotherapy and age on the occurence of lymphedema were evaluated. RESULTS: ln that period (mean follow-up time: 40.8+14.8 months (12-72)), 93 female patients (mean age 49.9+13.7) were treated with MRM. Radiotherapy was performed to 44 (% 47.3) patients. Arm lymphedema occured in 7 patients (% 7.5). The earliest lymphedema of the arm occured in postoperative 6. month in 2 cases and after 1. year in postoperative period in 5 cases; the mean occurence time of the lymphedema was 24.8+16.5 (6-44) months. ln the evaluation, lymphedema was detected in 6/ 44 (% 12.6) patients who had radiotherapy. Radiotherapy was detected as the only significant risk factor for the development of the arm lymphedema (p< 0.05). The other factors were nonsignificant. CONCLUSIONS: Radiotheraphy is a predominant risk factor for lymphedema of the arm in patients performed MRM for breast cancer. The prolonged regular followup of the patients for the possible arm lymphedema development is considerable for the early diagnosis and conservative precautions that would be performed instantly.