Time-Dependent Changes in the Skin Hardness in Taxane-Induced Swollen Arms

Background: We aimed to clarify the time-dependent changes in skin hardness in taxane-induced arm swelling. Methods and Results: Fifteen patients with unilateral arm swelling that developed during or within 3 months from the termination of postoperative taxane-containing chemotherapy were studied. The patients were followed up every 3-6 months for 24 months from the initial visit. During each visit, arm circumference and skin hardness were assessed using a scale ranging from 1 (softest) to 7 (hardest). Ultrasonography of the skin and subcutaneous tissues was performed at 0, 6, 12, and 24 months from the initial visit. In the initial visit, the mean skin hardness in the affected and contralateral arms was 3.8 versus 2.8 (p < 0.05) in the medial/lateral upper arm, 5.0 versus 2.8 (p < 0.01) in the medial forearm, and 4.3 versus 2.8 (p < 0.05) in the lateral forearm. In 12 patients whose arm swelling resolved, the difference in skin hardness between the arms disappeared in 9 patients until 9 months from the initial visit, whereas a mild difference in skin hardness persisted in the remaining 3 patients. Even in three patients whose arm swelling persisted, a certain improvement was observed until 9-12 months from the initial visit. Conclusions: We found that the majority of skin hardening associated with taxane-induced arm swelling improved until approximately 9-12 months from the initial visit, including complete resolution in 60% of patients.