Lymphoedema: a current real world prospective evaluation.

Area of Science:

• Oncology
• Surgical Oncology
• Lymphedema Research

Background:

• Breast-cancer-related-lymphoedema (BCRL) is a significant clinical challenge.
• Incidence rates vary, with higher rates associated with more extensive lymph node dissection (e.g., axillary lymph node dissection [ALND] vs. sentinel lymph node biopsy [SLNB]).

Purpose of the Study:

• To prospectively assess the incidence of BCRL in symptomatic breast cancer patients undergoing axillary surgery.
• To evaluate BCRL incidence based on surgical procedure (SLNB vs. ALND) and extent of axillary staging (with or without level I/II axillary lymph node dissection).

Main Methods:

• Prospective, single-center study from January 2016 to July 2019.
• Inclusion of 147 symptomatic breast cancer patients.
• Limb volume assessment using standardized arm circumference measurement and water displacement at pre-operative, 1-year, and 2-year post-operative time points.

Main Results:

• Overall BCRL incidence at 2 years was 6.1% (arm circumference) and 15.7% (water displacement).
• Incidence varied by surgical group: SLNB alone (4.3% circumference, 10.6% water displacement), SLNB + RLNR (33.3% circumference, 33.3% water displacement), ALND alone (11.5% circumference, 15.4% water displacement), ALND + RLNR (4.2% circumference, 33.3% water displacement).
• Significant differences in wide local excision rates and lymph node excision numbers between SLNB and ALND groups.

Conclusions:

• The study provides real-world data on BCRL diagnosis and incidence in breast cancer patients.
• BCRL incidence at this institution is low compared to international benchmarks.
• Findings highlight the importance of measurement methods and surgical approach in BCRL assessment.