A multicentre cross-sectional study of arm lymphedema four or more years after breast cancer treatment in Iranian patients.

BACKGROUND

We performed a cross-sectional multicentre study to assess the prevalence of lymphedema after breast cancer treatment in Iran.

PATIENTS AND METHODS

All female breast cancer patients who attended our follow-up clinics four or more years after their surgery with no sign of disease were asked to participate in this study. Lymphedema was defined as an increase of 10% in the circumference of the arm on the involved side compared to the opposite arm.

RESULTS

The total number of patients participating in this study was 355. The prevalence of lymphedema in the study patients was 17.5%, with the rate varying significantly (between 4 and 21%) among the three study centres (p = 0.007). The mean number of months post surgery was larger for patients with lymphedema (84 months) than for those without (79 months), though this was not statistically significant (p > 0.1). The relationships of various treatment factors and the education levels of the patients to the presence of lymphedema were also evaluated. None of the observed differences were statistically significant aside from those for the type of surgery (mastectomy vs. conservative surgery, p = 0.055), treatment with radiotherapy (p = 0.099), and prescription of a supraclavicular radiation field (p = 0.057), which were only just significant.

CONCLUSION

The rate of lymphedema in our patients was 17.5%, ranging from 4 to 21% in different study centres. Time post surgery, treatment with radiotherapy and the technique used, and nodal radiation seem to be factors that are related to this large variation.