Iatrogenic Breast Lymphoedema: Incidence, Diagnosis, and Associated Risk Factors

Area of Science:

• Oncology
• Medical Imaging
• Surgical Complications

Background:

• Upper limb lymphoedema post-breast cancer surgery is documented, but breast lymphoedema is rarely studied.
• Identifying risk factors and diagnostic methods for breast lymphoedema is crucial for patient care.

Purpose of the Study:

• To identify risk factors associated with breast lymphoedema.
• To evaluate the utility of breast ultrasound in assessing breast lymphoedema.

Main Methods:

• A case series analysis of 286 patients undergoing wide local excision for breast cancer.
• Clinical assessment and breast ultrasound scans at 6 and 12 months post-surgery.
• Comparison of ipsilateral and contralateral breast skin/subcutaneous thickness and parenchymal changes.

Main Results:

• Breast lymphoedema was identified in 7.7% of patients (22/286), defined by a ≥5mm increase in skin/subcutaneous thickness compared to the contralateral breast without significant radiotherapy changes.
• Risk factors identified include high body mass index (BMI), larger breast volume, upper outer quadrant tumors, and axillary lymph node clearance.
• Ultrasound demonstrated potential for assessing breast lymphoedema by measuring tissue thickness.

Conclusions:

• Breast lymphoedema incidence in this cohort was 7.7%.
• High BMI, larger breast volume, specific tumor locations, and axillary lymph node clearance are associated with increased breast lymphoedema risk.
• A ≥5mm difference in skin/subcutaneous thickness may indicate breast lymphoedema, especially when radiotherapy changes are minimal.