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Indian Journal of Surgery

, Volume 81, Issue 1, pp 16–22 | Cite as

Post Mastectomy Lymphedema—a Prospective Study of Incidence and Risk Factors

  • Soumya Khanna
  • Ashish Kumar GuptaEmail author
  • Anish Jacob Cherian
  • Bijesh Yadav
  • Paul Mazhuvanchary Jacob
Original Article
  • 123 Downloads

Abstract

The aim of this study is to document the incidence of early lymphedema and study the risk factors influencing post mastectomy lymphedema. It is a prospective cohort study involving 98 adult women who underwent surgery including axillary lymph node dissection for biopsy-proven breast carcinoma. Serial measurements of the arm were taken preoperatively and postoperatively at 3, 6 and 12 months. Lymphedema was diagnosed if there was an increase in girth by more than 2 cm in the concerned limb. All patients received standard lymphedema prevention advice. Risk factors assessed were age, body mass index, comorbid conditions, hypertension, medications, socioeconomic status, upper limb symptoms, laterality of disease, type of surgery, stage of the disease, histopathology, node status, wound complication, receptor status, seroma volume, duration of seroma drainage, radiotherapy, chemotherapy, post radiation skin reaction and post therapy weight gain. The statistical analysis was done using chi-square test with SPSS version 16. The incidence of lymphedema was 23.47%. The univariate analysis showed that prolonged or high volume seroma, taxane-based chemotherapy, radiotherapy to axilla and skin necrosis following radiation were significantly associated with lymphedema. In the multivariate analysis, only post radiation skin necrosis was significant.

Keywords

Post mastectomy lymphedema Breast cancer-related lymphedema Upper limb oedema Arm lymphedema Lymphedema 

Notes

Acknowledgements

The authors would like to acknowledge Dr. Jayaprakash Muliyil, Professor, Department of Community Medicine, Christian Medical College, Vellore, for his help in analysing the data.

Compliance with Ethical Standards

This prospective observational cohort study was carried out at the Department of Plastic Surgery and Endocrine Surgery, Christian Medical College (CMC) Hospital, Vellore, from 2011 to 2013. The study was approved by the Institutional Review Board and ethics committee.

Conflict of Interests

The authors declare that they have no conflict of interest.

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Copyright information

© Association of Surgeons of India 2017

Authors and Affiliations

  • Soumya Khanna
    • 1
  • Ashish Kumar Gupta
    • 1
    Email author
  • Anish Jacob Cherian
    • 2
  • Bijesh Yadav
    • 2
  • Paul Mazhuvanchary Jacob
    • 2
  1. 1.Max Super Specialty Hospital, SaketNew DelhiIndia
  2. 2.Christian Medical College and HospitalVelloreIndia

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