Frequency of Lymphedema after Complete Axillary Lymph Node Dissection in Patients with Breast Cancer

Abstract

Objective: To assess the frequency of lymphedema of the arm and forearm after complete axillary lymph node dissection in patients with breast cancer at one year of follow-up and see its association with body mass index among breast cancer patients presenting at a tertiary care hospital in Karachi.

Study Design: Prospective longitudinal study.

Place and Duration of Study: Department of Medical Oncology, Jinnah Postgraduate Medical Center, Karachi, Pakistan, from Apr 2019 to 2020.

Methodology: One sixty-eight females of age 25-80 years who underwent complete axillary lymph node dissection for breast cancer were included in the study. A breast surgeon performed the axillary lymph node dissection with more than five years of experience. The patients were followed for one year post-operatively to determine the occurrence of lymphedema. All the demographic details and clinic-pathological findings were reported in the predesigned proforma.

Results: About 168 females (97.6%) out of 172 have undergone complete axillary lymph node dissection. Lymphedema was the most common complication among them (38.1%). Common side effect observed after axillary lymph node dissection was pain (66.1%), followed by heaviness (59.5%), firmness/tightness (46.4%) and numbness. The patients with Body mass index ≥ 25 kg/m2, right arm involved, exposure to radiotherapy and moderately differentiated tumour (grade-2) had a significantly higher occurrence of lymphedema (p<0.05).

Conclusion: Lymphedema is higher among breast cancer survivors during the first postoperative year. The risk of lymphedema can be reduced by avoiding potential factors like obesity and carefully selecting patients for postoperative radiotherapy.