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Breast Edema Following Breast-Conserving Surgery and Radiotherapy: Patient-Reported Prevalence, Determinants, and
Danny A Young-Afat1,2, Madelijn L Gregorowitsch1, Desirée H van den Bongard3
1Imaging Division, University Medical Center, Utrecht, the Netherlands.
JNCI Cancer Spectrum
|July 31, 2019
Summary
Breast edema, a common side effect after breast cancer surgery and radiotherapy, significantly impacts quality of life and increases pain. Early identification and discussion are crucial for patient care.
Area of Science:
- Oncology
- Surgical Oncology
- Radiotherapy
Background:
- Lymphedema of the arm is known to impair health-related quality of life (HR-QoL).
- Data regarding breast edema following breast cancer treatment are limited.
- This study addresses the prevalence, determinants, and HR-QoL impact of breast edema.
Purpose of the Study:
- To prospectively evaluate the patient-reported prevalence and determinants of breast edema.
- To assess the effect of breast edema on patient-reported HR-QoL and breast pain.
- To inform clinical practice and patient counseling regarding breast edema.
Main Methods:
- Prospective cohort study (UMBRELLA) of 836 patients undergoing breast-conserving surgery and radiotherapy.
- Patient-reported outcomes (breast edema, HR-QoL, breast pain) assessed using EORTC-C30/BR23 at multiple time points.
- Mixed-effects models used to analyze associations and impact, adjusting for confounders.
Main Results:
- 24.8% of patients reported breast edema within a median follow-up of 28 months.
- Prevalence peaked at 6 months post-treatment (12.4%).
- Factors associated with breast edema included larger tumor size, oncoplastic surgery, axillary lymph node dissection, and radiotherapy details. Breast edema independently correlated with increased breast pain, poorer QoL, physical functioning, and body image.
Conclusions:
- Breast edema is a frequent occurrence within the first year after breast-conserving surgery and radiotherapy.
- Breast edema is independently linked to diminished HR-QoL and increased breast pain.
- Findings underscore the importance of discussing breast edema with patients during shared decision-making.
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