FACTORS ASSOCIATED WITH THE DEVELOPMENT OF ARM LYMPHEDEMA FOLLOWING BREAST CANCER TREATMENT: A MATCH PAIR CASE-CONTROL STUDY

Abstract

We examined factors that may influence the development of arm lymphedema followingbreast cancer treatment including the specific mode of therapy, patient occupation and life style.Medical record data and a questionnaire were used to collect information after surgeryconcerning such issues as wound seroma, infection, adjuvant treatment, vessel string (phlebitis),body mass index, smoking habits and stress. Occupational workload was assessed after surgerywhereas housework, exercise, hobbies and body weight were assessed both before and aftersurgery. Seventy-one breast cancer treated women with arm lymphedema lasting more than 6months but less than 2 years were matched to women similarly treated for breast cancer butwithout arm lymphedema (controls). The matching factors included axillary node status, timeafter axillary dissection, and age. In the lymphedema group, there was a higher body mass indexat time of surgery (p=0.03) as well at time of study (p=0.04). No differences were found inoccupational workload (n=38) or housework, but the lymphedema group reduced their sparetime activities including exercise after surgery compared with the controls (p<0.01).In conclusion, women treated for breast cancer with axillary node dissection with orwithout adjuvant radiotherapy could maintain their level of physical activity and occupationalworkload after treatment without an added risk of developing arm lymphedema. On the otherhand, a Higher BMI before and after operation obesity increases the lymphedema risk.