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Transient swelling versus lymphoedema in the first year following surgery for breast cancer

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Abstract

Purpose

The aim was to better understand the incidence, time course and risk factors for swelling in the arm on the side of surgery over the first year following surgery for breast cancer.

Method

Women (n = 160) were assessed 1 month following surgery and then randomised to the exercise or control group. Reassessment occurred 3, 9 and 15 months following surgery. Potential risk factors for swelling included age, body mass index, side of surgery and surgical and medical treatments for their breast cancer, physical measures of shoulder range of motion and strength, inter-limb arm circumference difference and the group to which they were randomised. Swelling was determined using bioimpedance spectroscopy with reference to previously established cut-offs for lymphoedema.

Results

The number of women with swelling at 3, 9 and 15 months was 15, 15 and 13, respectively; however, at 15 months only 5/13 presented with swelling in either of the preceding assessments. The risk of swelling increased at 3, 9 and 15 months for each centimetre increase in the baseline inter-limb difference in sum of arm circumferences by 1.30, 1.17 and 1.14. In addition, risk of swelling at 3 months was 2.6 times greater for women in the control group; at 9 months, 7 times greater for women who had taxane-based chemotherapy; and at 15 months, the risk increased 1.16 times for each day the drain was in situ.

Conclusion

Swelling in the first year is likely to be transient, and factors including exercise and taxane chemotherapy affect the risk of developing swelling.

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Acknowledgments

The Cancer Council NSW provided a grant to support this project. SLK is supported by the National Breast Cancer Foundation, Australia.

Conflict of interest

Author Ward has consulted to ImpediMed Ltd. ImpediMed Ltd. had no involvement in the conception and execution of this study or in the preparation of the manuscript.

Author information

Authors and Affiliations

  1. Faculty of Health Sciences, University of Sydney, PO Box 170, Lidcombe, Sydney, 1825, New South Wales, Australia

    Sharon L. Kilbreath, Mi-Joung Lee, Kathryn M. Refshauge, Leigh C. Ward & D. Black

  2. Royal Prince Alfred Hospital, Sydney Cancer Centre, Camperdown, Australia

    Jane M. Beith

  3. School of Chemistry and Molecular Biosciences, The University of Queensland, Brisbane, Australia

    Leigh C. Ward

  4. School of Public Health, University of Sydney, Sydney, Australia

    J. M. Simpson

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  1. Sharon L. Kilbreath
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  2. Mi-Joung Lee
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  5. Leigh C. Ward
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  7. D. Black
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Correspondence to Sharon L. Kilbreath.

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Kilbreath, S.L., Lee, MJ., Refshauge, K.M. et al. Transient swelling versus lymphoedema in the first year following surgery for breast cancer. Support Care Cancer 21, 2207–2215 (2013). https://doi.org/10.1007/s00520-013-1770-2

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  • DOI: https://doi.org/10.1007/s00520-013-1770-2

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