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Early-stage breast cancer: arm edema after wide excision and breast irradiation
1Department of Radiation Oncology, Northwestern Memorial Hospital, Chicago, IL, USA.
Purpose:
To determine the incidence of arm edema in women with early-stage breast cancer after breast-conserving surgery and irradiation.
Materials And Methods:
Women aged 29-83 years (mean, 55.9 years) treated with breast-conserving surgery and irradiation (n = 183) underwent a series of measurements of the circumference of each arm. Patient and treatment factors were analyzed for predictive value.
Results:
Arm edema developed in 35.0% (n = 64), and clinically significant edema developed in 17.5% (n = 32) of patients. Dissections that yielded 16 or more nodes led to a 44% actuarial incidence of edema and a 29% actuarial incidence of clinically significant edema. Clinically significant arm changes occurred in 19 of the 87 (22%) women older than 55 years and in 13 of the 96 (14%) women younger than 55 years (P = .002). Chemotherapy, breast radiation dose, and use of tamoxifen had no effect on development of edema.
Conclusion:
Axillary dissection producing more than 15 nodes and age older than 55 years are predictive of arm edema.