Kiel K D, Rademacker A W
Department of Radiation Oncology, Northwestern Memorial Hospital, Chicago, IL, USA.
Radiology. 1996 Jan;198(1):279-83. doi: 10.1148/radiology.198.1.8539394.
To determine the incidence of arm edema in women with early-stage breast cancer after breast-conserving surgery and irradiation.
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.
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.
Axillary dissection producing more than 15 nodes and age older than 55 years are predictive of arm edema.
确定保乳手术及放疗后的早期乳腺癌女性患者手臂水肿的发生率。
年龄在29 - 83岁（平均55.9岁）接受保乳手术及放疗的女性患者（n = 183）接受了一系列双臂周长测量。分析患者及治疗因素的预测价值。
35.0%（n = 64）的患者出现手臂水肿，17.5%（n = 32）的患者出现具有临床意义的水肿。清扫出16个或更多淋巴结的患者，水肿的精算发病率为44%，具有临床意义的水肿精算发病率为29%。87名55岁以上女性中有19名（22%）出现具有临床意义的手臂变化，96名55岁以下女性中有13名（14%）出现此类变化（P = .002）。化疗、乳腺放疗剂量及他莫昔芬的使用对水肿的发生无影响。
腋窝清扫出超过15个淋巴结以及年龄超过55岁可预测手臂水肿。
