Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

Keynote webinar | Spotlight on medication adherence

LIVE: Thursday 27th June 2024, 18:00-19:30 (CEST)
Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.
ADVANCED SEARCH
Log in
Top
Annals of Surgical Oncology
Published in: Annals of Surgical Oncology 7/2009

01-07-2009 | Breast Oncology

The Risk of Developing Arm Lymphedema Among Breast Cancer Survivors: A Meta-Analysis of Treatment Factors

Authors: Rebecca J. Tsai, MS, Leslie K. Dennis, PhD, Charles F. Lynch, MD, PhD, Linda G. Snetselaar, RD, PhD, LD, Gideon K. D. Zamba, PhD, Carol Scott-Conner, MD, PhD, MBA

Published in: Annals of Surgical Oncology | Issue 7/2009

Login to get access

Abstract

Background

As more women survive breast cancer, long-term complications that affect quality of life, such as lymphedema of the arm, gain greater importance. Numerous studies have attempted to identify treatment and prognostic factors for arm lymphedema, yet the magnitude of these associations remains inconsistent.

Methods

A PubMed search was conducted through January 2008 to locate articles on lymphedema and treatment factors after breast cancer diagnosis. Random-effect models were used to estimate the pooled risk ratio.

Results

The authors identified 98 independent studies that reported at least one risk factor of interest. The risk ratio (RR) of arm lymphedema was increased after mastectomy when compared with lumpectomy [RR = 1.42; 95% confidence interval (CI) 1.15–1.76], axillary dissection compared with no axillary dissection (RR = 3.47; 95% CI 2.34–5.15), axillary dissection compared with sentinel node biopsy (RR = 3.07; 95% CI 2.20–4.29), radiation therapy (RR = 1.92; 95% CI 1.61–2.28), and positive axillary nodes (RR = 1.54; 95% CI 1.32–1.80). These associations held when studies using self-reported lymphedema were excluded.

Conclusions

Mastectomy, extent of axillary dissection, radiation therapy, and presence of positive nodes increased risk of developing arm lymphedema after breast cancer. These factors likely reflected lymph node removal, which most surgeons consider to be the largest risk factor for lymphedema. Future studies should consider examining sentinel node biopsy versus no dissection with a long follow-up time post surgery to see if there is a benefit of decreased lymphedema compared with no dissection.
Literature
1.
Jemal A, Siegel R, Ward E, Hao Y, Xu J, Murray T, et al. Cancer statistics, 2008. CA Cancer J Clin. 2008;58(2):71–96.PubMedCrossRef
2.
Petrek JA, Heelan MC. Incidence of breast carcinoma-related lymphedema. Cancer. 1998;83(12 Suppl American):2776–81.PubMedCrossRef
3.
Sakorafas GH, Peros G, Cataliotti L, Vlastos G. Lymphedema following axillary lymph node dissection for breast cancer. Surg Oncol. 2006;15(3):153–65.PubMedCrossRef
4.
Petrek JA, Senie RT, Peters M, Rosen PP. Lymphedema in a cohort of breast carcinoma survivors 20 years after diagnosis. Cancer. 2001;92(6):1368–77.PubMedCrossRef
5.
Deo SV, Ray S, Rath GK, Shukla NK, Kar M, Asthana S, et al. Prevalence and risk factors for development of lymphedema following breast cancer treatment. Indian J Cancer. 2004;41(1):8–12.PubMed
6.
7.
Woolf B. On estimating the relation between blood group and disease. Ann Hum Genet. 1955;19(4):251–3.PubMedCrossRef
8.
Meric F, Buchholz TA, Mirza NQ, Vlastos G, Ames FC, Ross MI, et al. Long-term complications associated with breast-conservation surgery and radiotherapy [see comment]. Ann Surg Oncol. 2002;9(6):543–9.PubMed
9.
Daland EM. The incidence of swollen arms after radical mastectomy and suggestions for prevention. New Engl J Med. 1950;242:497–502.
10.
Johansen J, Overgaard J, Blichert-Toft M, Overgaard M. Treatment of morbidity associated with the management of the axilla in breast-conserving therapy. Acta Oncol. 2000;39(3):349–54.PubMedCrossRef
11.
Querci della Rovere G, Ahmad I, Singh P, Ashley S, Daniels IR, Mortimer P. An audit of the incidence of arm lymphoedema after prophylactic level I/II axillary dissection without division of the pectoralis minor muscle. Ann R Coll Surg Engl. 2003;85(3):158–61.PubMedCrossRef
12.
Tasmuth T, von Smitten K, Kalso E. Pain and other symptoms during the first year after radical and conservative surgery for breast cancer. Br J Cancer. 1996;74(12):2024–31.PubMed
13.
Duff M, Hill AD, McGreal G, Walsh S, McDermott EW, O’Higgins NJ. Prospective evaluation of the morbidity of axillary clearance for breast cancer [see comment]. Br J Surg. 2001;88(1):114–7.PubMedCrossRef
14.
Feigenberg Z, Zer M, Dintsman M. Comparison of postoperative complications following radical and modified radical mastectomy. World J Surg. 1977;2(1):207–11.PubMedCrossRef
15.
Baron RH, Fey JV, Raboy S, Thaler HT, Borgen PI, Temple LK, et al. Eighteen sensations after breast cancer surgery: a comparison of sentinel lymph node biopsy and axillary lymph node dissection. Oncology Nursing Forum. Online 2002;29(4):651–9.PubMedCrossRef
16.
Clark B, Sitzia J, Harlow W. Incidence and risk of arm oedema following treatment for breast cancer: a three-year follow-up study. Q J Med. 2005;98(5):343–8.
17.
Mortimer PS, Bates DO, Brassington HD, Stanton AWB, Strachan DP, Levick JR. The prevalence of arm oedema following treatment for breast cancer. Q J Med. 1996(89):377–80.
18.
Ridner SH. Pretreatment lymphedema education and identified educational resources in breast cancer patients. Patient Educ Couns. 2006;61(1):72–9.PubMedCrossRef
19.
Schunemann H, Willich N. Lymphoedema of the arm after primary treatment of breast cancer. Anticancer Res. 1998;18(3):2235–6.PubMed
20.
Veronesi U, Saccozzi R, Del Vecchio M, Banfi A, Clemente C, De Lena M, et al. Comparing radical mastectomy with quadrantectomy, axillary dissection, and radiotherapy in patients with small cancers of the breast. N Engl J Med. 1981;305(1):6–11.PubMed
21.
Brismar B, Ljungdahl I. Postoperative lymphoedema after treatment of breast cancer. Acta Chir Scand. 1983;149(7):687–9.PubMed
22.
Geller BM, Vacek PM, O’Brien P, Secker-Walker RH. Factors associated with arm swelling after breast cancer surgery. J Women’s Health. 2003;12(9):921–30.CrossRef
23.
Edwards TL. Prevalence and aetiology of lymphoedema after breast cancer treatment in southern Tasmania. Aust NZ J Surg. 2000;70(6):412–8.CrossRef
24.
Liljegren G, Holmberg L. Arm morbidity after sector resection and axillary dissection with or without postoperative radiotherapy in breast cancer stage I. Results from a randomised trial. Uppsala-Orebro Breast Cancer Study Group. Eur J Cancer. 1997;33(2):193–9.PubMedCrossRef
25.
Nagel PH, Bruggink ED, Wobbes T, Strobbe LJ. Arm morbidity after complete axillary lymph node dissection for breast cancer. Acta Chir Belg. 2003;103(2):212–6.PubMed
26.
Schijven MP, Vingerhoets AJ, Rutten HJ, Nieuwenhuijzen GA, Roumen RM, van Bussel ME, et al. Comparison of morbidity between axillary lymph node dissection and sentinel node biopsy. Eur J Surg Oncol. 2003;29(4):341–50.PubMedCrossRef
27.
van der Veen P, De Voogdt N, Lievens P, Duquet W, Lamote J, Sacre R. Lymphedema development following breast cancer surgery with full axillary resection. Lymphology. 2004;37(4):206–8.PubMed
28.
Ververs JM, Roumen RM, Vingerhoets AJ, Vreugdenhil G, Coebergh JW, Crommelin MA, et al. Risk, severity and predictors of physical and psychological morbidity after axillary lymph node dissection for breast cancer. Eur J Cancer. 2001;37(8):991–9.PubMedCrossRef
29.
30.
Adjuvant Therapy for Breast Cancer. NIH consensus statement. Online November 1–3, 2000;17(4):1–23.
31.
Engel J, Kerr J, Schlesinger-Raab A, Eckel R, Sauer H, Holzel D. Predictors of quality of life of breast cancer patients. Acta Oncol. 2003;42(7):710–8.PubMedCrossRef
32.
Haines TP, Sinnamon P. Early arm swelling after breast surgery: changes on both sides. Breast Cancer Res Treat. 2007;101(1):105–12.PubMedCrossRef
33.
Langer I, Guller U, Berclaz G, Koechli OR, Schaer G, Fehr MK, et al. Morbidity of sentinel lymph node biopsy (SLN) alone versus SLN and completion axillary lymph node dissection after breast cancer surgery: a prospective Swiss multicenter study on 659 patients. Ann Surg. 2007;245(3):452–61.PubMedCrossRef
34.
Graham P, Jagavkar R, Browne L, Millar E. Supraclavicular radiotherapy must be limited laterally by the coracoid to avoid significant adjuvant breast nodal radiotherapy lymphoedema risk. Australas Radiol. 2006;50(6):578–82.PubMedCrossRef
35.
Lee TS, Kilbreath SL, Refshauge KM, Pendlebury SC, Beith JM, Lee MJ. Pectoral stretching program for women undergoing radiotherapy for breast cancer. Breast Cancer Res Treat. 2007;102(3):313–21.
36.
Mathew J, Barthelmes L, Neminathan S, Crawford D. Comparative study of lymphoedema with axillary node dissection versus axillary node sampling with radiotherapy in patients undergoing breast conservation surgery. Eur J Surg Oncol. 2006;32(7):729–32.PubMedCrossRef
37.
Schulze T, Mucke J, Markwardt J, Schlag PM, Bembenek A. Long-term morbidity of patients with early breast cancer after sentinel lymph node biopsy compared to axillary lymph node dissection. J Surg Oncol. 2006;93(2):109–19.PubMedCrossRef
38.
Soran A, D’Angelo G, Begovic M, Ardic F, Harlak A, Samuel Wieand H, et al. Breast cancer-related lymphedema–what are the significant predictors and how they affect the severity of lymphedema? Breast J. 2006;12(6):536–43.PubMedCrossRef
39.
Wilke LG, McCall LM, Posther KE, Whitworth PW, Reintgen DS, Leitch AM, et al. Surgical complications associated with sentinel lymph node biopsy: results from a prospective international cooperative group trial. Ann Surg Oncol. 2006;13(4):491–500.PubMedCrossRef
40.
Purushotham AD, Upponi S, Klevesath MB, Bobrow L, Millar K, Myles JP, et al. Morbidity after sentinel lymph node biopsy in primary breast cancer: results from a randomized controlled trial. J Clin Oncol. 2005;23(19):4312–21.PubMedCrossRef
41.
Ronka R, von Smitten K, Tasmuth T, Leidenius M. One-year morbidity after sentinel node biopsy and breast surgery. Breast. 2005;14(1):28–36.PubMedCrossRef
42.
Armer J, Fu MR, Wainstock JM, Zagar E, Jacobs LK. Lymphedema following breast cancer treatment, including sentinel lymph node biopsy. Lymphology. 2004;37(2):73–91.PubMed
43.
Golshan M, Martin WJ, Dowlatshahi K. Sentinel lymph node biopsy lowers the rate of lymphedema when compared with standard axillary lymph node dissection. Am Surg. 2003;69(3):209–11; discussion 212.PubMed
44.
Powell SN, Coen JJ, Taghian AG, Kachnic LA, Assaad SI. Risk of lymphedema after regional nodal irradiation with breast conservation therapy. Int J Radiat Oncol Biol Phys. 2003;55(5):1209–15 [erratum Int J Radiat Oncol Biol Phys. 2003 Jun 1;56(2):604].PubMed
45.
Albrecht MR, Zink K, Busch W, Ruhl U. Dissection or irradiation of the axilla in postmenopausal patients with breast cancer? Long-term results and long-term effects in 655 patients. Strahlenther Onkol. 2002;178(9):510–6.PubMedCrossRef
46.
Haid A, Koberle-Wuhrer R, Knauer M, Burtscher J, Fritzsche H, Peschina W, et al. Morbidity of breast cancer patients following complete axillary dissection or sentinel node biopsy only: a comparative evaluation. Breast Cancer Res Treat. 2002;73(1):31–6.PubMedCrossRef
47.
Herd-Smith A, Russo A, Muraca MG, Del Turco MR, Cardona G. Prognostic factors for lymphedema after primary treatment of breast carcinoma. Cancer. 2001;92(7):1783–7.PubMedCrossRef
48.
Hojris I, Andersen J, Overgaard M, Overgaard J. Late treatment-related morbidity in breast cancer patients randomized to postmastectomy radiotherapy and systemic treatment versus systemic treatment alone. Acta Oncol. 2000;39(3):355–72.PubMedCrossRef
49.
Schunemann H, Willich N. Lymphedema after breast carcinoma A study of 5868 cases. Dtsch Med Wochenschr. 1997;122(17):536–41.PubMedCrossRef
50.
Ferrandez JC, Serin D, Bouges S. Frequency of lymphedema of the upper limb after treatment of breast cancer Risk factors Apropos of 683 cases. Bull Cancer. 1996;83(12):989–95.PubMed
51.
Kiel KD, Rademacker AW. Early-stage breast cancer: arm edema after wide excision and breast irradiation. Radiology. 1996;198(1):279–83.PubMed
52.
Paci E, Cariddi A, Barchielli A, Bianchi S, Cardona G, Distante V, et al. Long-term sequelae of breast cancer surgery. Tumori. 1996;82(4):321–4.PubMed
53.
Keramopoulos A, Tsionou C, Minaretzis D, Michalas S, Aravantinos D. Arm morbidity following treatment of breast cancer with total axillary dissection: a multivariated approach. Oncology. 1993;50(6):445–9.PubMed
54.
Gerber L, Lampert M, Wood C, Duncan M, D’Angelo T, Schain W, et al. Comparison of pain, motion, and edema after modified radical mastectomy vs local excision with axillary dissection and radiation. Breast Cancer Res Treat. 1992;21(2):139–45.PubMedCrossRef
55.
Werner RS, McCormick B, Petrek J, Cox L, Cirrincione C, Gray JR, et al. Arm edema in conservatively managed breast cancer: obesity is a major predictive factor. Radiology. 1991;180(1):177–84.PubMed
56.
Ryttov N, Holm NV, Qvist N, Blichert-Toft M. Influence of adjuvant irradiation on the development of late arm lymphedema and impaired shoulder mobility after mastectomy for carcinoma of the breast. Acta Oncol. 1988;27(6A):667–70.PubMedCrossRef
57.
Borger JH, Keijser AH. Conservative breast cancer treatment: analysis of cosmetic results and the role of concomitant adjuvant chemotherapy. Int J Radiat Oncol Biol Phys. 1987;13(8):1173–7.PubMed
58.
Delouche G, Bachelot G, Premont M, Kurtz J. Conservation treatment of early breast cancer: long term results and complications. Int J Radiat Oncol Biol Phys. 1986;13:29–34.
59.
Penzer R. Lymphoedema. Nursing Standard 2003;17(35):45–51; quiz 52.PubMed
60.
Pierquin B, Mazeron JJ, Glaubiger D. Conservative treatment of breast cancer in Europe: report of the Groupe Europeen de Curietherapie. Radiother Oncol. 1986;6(3):187–98.PubMedCrossRef
61.
Kuno K, Fukami A, Kasumi F, Hori M, Watanabe S. Lymphedema and function of the arm after mastectomy for breast cancer. Gan No Rinsho. 1984;30(6 Suppl):670–3.PubMed
62.
Watson TA, Bond AF, Phillips AJ. Swelling and dysfunction of the upper limb following radical mastectomy. Surg Gynecol Obstet. 1963;116:99–104.PubMed
63.
West JP, Ellison JB. A study of the causes and prevention of edema of the arm following radical mastectomy. Surg Gynecol Obstet. 1959;109:359–63.PubMed
64.
Treves N. An evaluation of the etiological factors of lymphedema following radical mastectomy; an analysis of 1,007 cases. Cancer. 1957;10(3):444–59.PubMedCrossRef
65.
Villasor RP, Lewison EF. Postmastectomy lymphedema; a clinical investigation into its causes and prevention. Surg Gynecol Obstet. 1955;100(6):743–52.PubMed
66.
Lobb AW, Harkins HN. Postmastectomy swelling of the arm; with a note on the effect of segmental resection of the axillary vein at the time of radical mastectomy. West J Surg Obstet Gynecol. 1949;57(11):550–7.PubMed
67.
Macdonald I. Resection of the axillary vein in radical mastectomy: its relation to the mechanism of lymphedema. Cancer. 1948;1(4):618–624.CrossRef
68.
Holman C, McSwain B, Beal JM. Swelling of the upper extremity following radical mastectomy. Surgery. 1944;15:757–765.
69.
Hayes S, Cornish B, Newman B. Comparison of methods to diagnose lymphoedema among breast cancer survivors: 6-month follow-up. Breast Cancer Res Treat. 2005;89(3):221–6.PubMedCrossRef
70.
Sener SF, Winchester DJ, Martz CH, Feldman JL, Cavanaugh JA, Winchester DP, et al. Lymphedema after sentinel lymphadenectomy for breast carcinoma. Cancer. 2001;92(4):748–52.PubMedCrossRef
71.
Beaulac SM, McNair LA, Scott TE, LaMorte WW, Kavanah MT. Lymphedema and quality of life in survivors of early-stage breast cancer. Arch Surg. 2002;137(11):1253–7.PubMedCrossRef
72.
Box RC, Reul-Hirche HM, Bullock-Saxton JE, Furnival CM. Physiotherapy after breast cancer surgery: results of a randomised controlled study to minimise lymphoedema. Breast Cancer Res Treat. 2002;75(1):51–64.PubMedCrossRef
73.
Kwan W, Jackson J, Weir LM, Dingee C, McGregor G, Olivotto IA. Chronic arm morbidity after curative breast cancer treatment: prevalence and impact on quality of life. J Clin Oncol. 2002;20(20):4242–8.PubMedCrossRef
74.
Johansson K, Ingvar C, Albertsson M, Ekdahl C. Arm Lymphoedema Shoulder mobility and muscle strength after breast cancer treatment. A prospective 2-year study. Adv Physiother. 2001(3):55–66.
75.
Tengrup I, Tennvall-Nittby L, Christiansson I, Laurin M. Arm morbidity after breast-conserving therapy for breast cancer. Acta Oncol. 2000;39(3):393–7.PubMedCrossRef
76.
Thompson AM, Air M, Jack WJL, Kerr GR, Rodger A, Chetty U. Arm morbidity after breast conservation and axillary therapy. Breast. 1995(4):273–6.
77.
Hladiuk M, Huchcroft S, Temple W, Schnurr BE. Arm function after axillary dissection for breast cancer: a pilot study to provide parameter estimates. J Surg Oncol. 1992;50(1):47–52.PubMedCrossRef
78.
Segerstrom K, Bjerle P, Graffman S, Nystrom A. Factors that influence the incidence of brachial oedema after treatment of breast cancer. Scand J Plast Reconstr Surg Hand Surg. 1992;26(2):223–7.PubMedCrossRef
79.
Swedborg I, Wallgren A. The effect of pre- and postmastectomy radiotherapy on the degree of edema, shoulder-joint mobility, and gripping force. Cancer. 1981;47(5):877–81.PubMedCrossRef
80.
Nikkanen TA, Vanharanta H, Helenius-Reunanen H. Swelling of the upper extremity, function and muscle strength of shoulder joint following mastectomy combined with radiotherapy. Ann Clin Res. 1978;10(5):273–9.PubMed
81.
Bani HA, Fasching PA, Lux MM, Rauh C, Willner M, Eder I, et al. Lymphedema in breast cancer survivors: assessment and information provision in a specialized breast unit. Patient Educ Couns. 2007;66(3):311–8.
82.
Paskett ED, Naughton MJ, McCoy TP, Case LD, Abbott JM. The epidemiology of arm and hand swelling in premenopausal breast cancer survivors. Cancer Epidemiol Biomarkers Prev. 2007;16(4):775–82.PubMedCrossRef
83.
Mansel RE, Fallowfield L, Kissin M, Goyal A, Newcombe RG, Dixon JM, et al. Randomized multicenter trial of sentinel node biopsy versus standard axillary treatment in operable breast cancer: the ALMANAC Trial. J Natl Cancer Inst. 2006;98(9):599–609.PubMed
84.
Barranger E, Dubernard G, Fleurence J, Antoine M, Darai E, Uzan S. Subjective morbidity and quality of life after sentinel node biopsy and axillary lymph node dissection for breast cancer. J Surg Oncol. 2005;92(1):17–22.PubMedCrossRef
85.
Karki A, Simonen R, Malkia E, Selfe J. Impairments, activity limitations and participation restrictions 6 and 12 months after breast cancer operation. J Rehabil Med. 2005;37(3):180–8.PubMed
86.
Blanchard DK, Donohue JH, Reynolds C, Grant CS. Relapse and morbidity in patients undergoing sentinel lymph node biopsy alone or with axillary dissection for breast cancer. Arch Surg. 2003;138(5):482–7; discussion 487–8.PubMedCrossRef
87.
Yap KP, McCready DR, Narod S, Manchul LA, Trudeau M, Fyles A. Factors influencing arm and axillary symptoms after treatment for node negative breast carcinoma. Cancer. 2003;97(6):1369–75.PubMedCrossRef
88.
Swenson KK, Nissen MJ, Ceronsky C, Swenson L, Lee MW, Tuttle TM. Comparison of side effects between sentinel lymph node and axillary lymph node dissection for breast cancer. Ann Surg Oncol. 2002;9(8):745–53.PubMedCrossRef
89.
Schrenk P, Rieger R, Shamiyeh A, Wayand W. Morbidity following sentinel lymph node biopsy versus axillary lymph node dissection for patients with breast carcinoma. Cancer. 2000;88(3):608–14.PubMedCrossRef
90.
Maunsell E, Brisson J, Deschenes L. Arm problems and psychological distress after surgery for breast cancer. Can J Surg. 1993;36(4):315–20.PubMed
91.
Sarin R, Dinshaw KA, Shrivastava SK, Sharma V, Deore SM. Therapeutic factors influencing the cosmetic outcome and late complications in the conservative management of early breast cancer. Int J Radiat Oncol Biol Phys. 1993;27(2):285–92.PubMed
92.
Aitken RJ, Gaze MN, Rodger A, Chetty U, Forrest AP. Arm morbidity within a trial of mastectomy and either nodal sample with selective radiotherapy or axillary clearance. Br J Surg. 1989;76(6):568–71.PubMedCrossRef
93.
Kissin MW, Querci della Rovere G, Easton D, Westbury G. Risk of lymphoedema following the treatment of breast cancer. Br J Surg. 1986;73(7):580–4.PubMedCrossRef
94.
Hinrichs CS, Watroba NL, Rezaishiraz H, Giese W, Hurd T, Fassl KA, et al. Lymphedema secondary to postmastectomy radiation: incidence and risk factors. Ann Surg Oncol. 2004;11(6):573–80.PubMedCrossRef
95.
Johansson K, Ohlsson K, Ingvar C, Albertsson M, Ekdahl C. Factors associated with the development of arm lymphedema following breast cancer treatment: a match pair case-control study [see comment]. Lymphology. 2002;35(2):59–71.PubMed
96.
Suneson BL, Lindholm C, Hamrin E. Clinical incidence of lymphoedema in breast cancer patients in Jonkoping County, Sweden. Eur J Cancer Care (Engl). 1996;5(1):7–12.CrossRef
97.
Cabanes PA, Salmon RJ, Vilcoq JR, Durand JC, Fourquet A, Gautier C, et al. Value of axillary dissection in addition to lumpectomy and radiotherapy in early breast cancer The Breast Carcinoma Collaborative Group of the Institut Curie. Lancet. 1992;339(8804):1245–8.PubMedCrossRef
98.
Hoe AL, Iven D, Royle GT, Taylor I. Incidence of arm swelling following axillary clearance for breast cancer. Br J Surg. 1992;79(3):261–2.PubMedCrossRef
99.
Senofsky GM, Moffat FL Jr, Davis K, Masri MM, Clark KC, Robinson DS, et al. Total axillary lymphadenectomy in the management of breast cancer. Arch Surg. 1991;126(11):1336–41; discussion 1341–2.PubMed
100.
Dewar JA, Sarrazin D, Benhamou E, Petit JY, Benhamou S, Arriagada R, et al. Management of the axilla in conservatively treated breast cancer: 592 patients treated at Institut Gustave-Roussy. Int J Radiat Oncol Biol Phys. 1987;13(4):475–81.PubMed
101.
Larson D, Weinstein M, Goldberg I, Silver B, Recht A, Cady B, et al. Edema of the arm as a function of the extent of axillary surgery in patients with stage I–II carcinoma of the breast treated with primary radiotherapy. Int J Radiat Oncol Biol Phys. 1986;12(9):1575–82.PubMed
102.
Mozes M, Papa MZ, Karasik A, Reshef A, Adar R. The role of infection in post-mastectomy lymphedema. Surg Annu. 1982;14:73–83.PubMed
103.
Fitts WT, Keuhnelian JG, Ravdin IS, Schor S. Swelling of the arm after radical mastectomy. Surgery. 1954;35(3):460–4.PubMed
104.
Kopanski Z, Wojewoda T, Wojewoda A, Schlegel-Zawadzka M, Wozniacka R, Suder A, et al. Influence of some anthropometric parameters on the risk of development of distal complications after mastectomy carried out because of breast carcinoma. Am J Human Biol. 2003;15(3):433–9.CrossRef
105.
Giuliano AE, Haigh PI, Brennan MB, Hansen NM, Kelley MC, Ye W, et al. Prospective observational study of sentinel lymphadenectomy without further axillary dissection in patients with sentinel node-negative breast cancer. J Clin Oncol. 2000;18(13):2553–9.PubMed
106.
Ragaz J, Jackson SM, Le N, Plenderleith IH, Spinelli JJ, Basco VE, et al. Adjuvant radiotherapy and chemotherapy in node-positive premenopausal women with breast cancer. N Engl J Med. 1997;337(14):956–62.PubMedCrossRef
107.
Pierquin B, Huart J, Raynal M, Otmezguine Y, Calitchi E, Mazeron JJ, et al. Conservative treatment for breast cancer: long-term results (15 years). Radiother Oncol. 1991;20(1):16–23.PubMedCrossRef
108.
Benson EA, Thorogood J. The effect of surgical technique on local recurrence rates following mastectomy. Eur J Surg Oncol. 1986;12(3):267–71.PubMed
109.
Say CC, Donegan W. A biostatistical evaluation of complications from mastectomy. Surg Gynecol Obstet. 1974;138(3):370–6.PubMed
110.
Nicholson WMP, Grady ED. Carcinoma of the Breast. Ann Surg. 1948;127(5):992–1008.CrossRef
Metadata
Title
The Risk of Developing Arm Lymphedema Among Breast Cancer Survivors: A Meta-Analysis of Treatment Factors
Authors
Rebecca J. Tsai, MS
Leslie K. Dennis, PhD
Charles F. Lynch, MD, PhD
Linda G. Snetselaar, RD, PhD, LD
Gideon K. D. Zamba, PhD
Carol Scott-Conner, MD, PhD, MBA
Publication date
01-07-2009
Publisher
Springer-Verlag
Published in
Annals of Surgical Oncology / Issue 7/2009
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI
https://doi.org/10.1245/s10434-009-0452-2

Other articles of this Issue 7/2009

Annals of Surgical Oncology 7/2009 Go to the issue

Endocrine Tumors

Clinical and Pathological Factors Related to 18F-FDG-PET Positivity in the Diagnosis of Recurrence and/or Metastasis in Patients with Differentiated Thyroid Cancer

CONSENSUS REPORT: RESECTABLE AND BORDERLINE RESECTABLE PANCREAS CANCER

Editorial: Combined Modality Treatment of Resectable and Borderline Resectable Pancreas Cancer: Expert Consensus Conference

Gastrointestinal Oncology

Adjustment of N Stages of Gastric Cancer by the Ratio Between the Metastatic and Examined Lymph Nodes

Gastrointestinal Oncology

Prediction of Recurrence of Early Gastric Cancer After Curative Resection

Breast Oncology

Video-Assisted Skin-Sparing Breast-Conserving Surgery for Breast Cancer and Immediate Reconstruction with Autologous Tissue: Clinical Outcomes

Translational Research and Biomarkers

Clinicopathologic Significance of KIAA1199 Overexpression in Human Gastric Cancer