Prevalence and prognostic significance of secondary lymphedema following breast cancer

The adverse consequences of lymphedema following breast cancer in relation to physical function and quality of life are clear; however, its potential relationship with survival has not been investigated. Our purpose was to determine the prevalence of lymphedema and associated upper-body symptoms at...

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Bibliographic Details
Published in:	Lymphatic research and biology Vol. 9; no. 3; p. 135
Main Authors:	Hayes, Sandi, Di Sipio, Tracey, Rye, Sheree, López, J Alejandro, Saunders, Christobel, Pyke, Chris, Bashford, John, Battistutta, Diana, Newman, Beth
Format:	Journal Article
Language:	English
Published:	United States 01-01-2011
Subjects:	Adult Aged Breast Neoplasms - complications Breast Neoplasms - mortality Female Humans Kaplan-Meier Estimate Lymphedema - epidemiology Lymphedema - etiology Middle Aged Prevalence Prognosis Risk Factors Time Factors
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Summary:	The adverse consequences of lymphedema following breast cancer in relation to physical function and quality of life are clear; however, its potential relationship with survival has not been investigated. Our purpose was to determine the prevalence of lymphedema and associated upper-body symptoms at 6 years following breast cancer and to examine the prognostic significance of lymphedema with respect to overall 6-year survival (OS). A population-based sample of Australian women (n = 287) diagnosed with invasive, unilateral breast cancer was followed for a median of 6.6 years and prospectively assessed for lymphedema (using bioimpedance spectroscopy [BIS], sum of arm circumferences [SOAC], and self-reported arm swelling), a range of upper-body symptoms, and vital status. OS was measured from date of diagnosis to date of death or last follow-up. Kaplan-Meier methods were used to calculate OS and Cox proportional hazards models quantified the risk associated with lymphedema. Approximately 45% of women had reported at least one moderate to extreme symptom at 6.6 years postdiagnosis, while 34% had shown clinical evidence of lymphedema, and 48% reported arm swelling at least once since baseline assessment. A total of 27 (9.4%) women died during the follow-up period, and lymphedema, diagnosed by BIS or SOAC between 6-18 months postdiagnosis, predicted mortality (BIS: HR = 2.5; 95% CI: 0.9, 6.8, p = 0.08; SOAC: 3.0; 95% CI: 1.1, 8.7, p = 0.04). There was no association (HR = 1.2; 95% CI: 0.5, 2.6, p = 0.68) between self-reported arm swelling and OS. These findings suggest that lymphedema may influence survival following breast cancer treatment and warrant further investigation in other cancer cohorts and explication of a potential underlying biology.
ISSN:	1557-8585
DOI:	10.1089/lrb.2011.0007