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Bone loss in the affected forearm in patients with breast cancer-related lymphedema: a controlled study

  • Secil Pervane Vural
  • F. Figen Ayhan
  • Burcu Duyur Cakit
  • Atilla Soran
Original Article

Abstract

Purpose

We aimed to investigate the association between lymphedema and bone mass density (BMD) of affected and unaffected forearms in patients with breast cancer-related lymphedema (BCRL). We also explored whether there was a relationship between any disability and BMD on the affected side.

Methods

We evaluated 111 patients (53.75 ± 9.07) with unilateral lymphedema (group 1) and 61 patients (50.90 ± 12.44) without lymphedema (group 2) after breast cancer surgery. BMD was performed by dual-energy x-ray absorptiometry (DXA) in lumbar spine, femoral neck, and distal forearm on both sides. Functional situation was assessed by the Disabilities of the Arm, Shoulder and Hand (QuickDASH) questionnaire.

Results

The total Z score (p = 0.018), T score (p = 0.005), and BMD value (p = 0.014) were lower in the affected forearm than the unaffected forearm in group 1. There was no difference between the affected or unaffected sides in the total Z score (p = 0.394), T score (p = 0.518), and BMD value (p = 0.629) in group 2. The DXA measurements in terms of the total forearm Z, T scores, and BMD value on the affected side were statistically significantly different between the groups. There was no difference between groups in the femur neck and lumbar total Z and T scores. There was also a positive correlation between the QuickDASH scores and lymphedema stage (r = 0.469, p = 0.001) and the duration without treatment of lymphedema (r = 0.298, p = 0.02) in group 1.

Conclusion

We recommend early diagnosis and treatment of lymphedema for the protection of upper extremity disability and localized osteoporosis in patients with BCRL.

Keywords

Lymphedema Osteoporosis Local bone loss QuickDASH Quality of life 

Notes

Compliance with ethical standards

The corresponding author has full control of all primary data and agrees to allow the journal to review the data if requested.

Conflict of interest

The authors declare that they have no conflict of interest.

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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  • Secil Pervane Vural
    • 1
  • F. Figen Ayhan
    • 1
  • Burcu Duyur Cakit
    • 1
  • Atilla Soran
    • 2
  1. 1.Department of Physical Medicine and Rehabilitation, Division of Oncological RehabilitationS.B.U Ankara Training and Research HospitalAnkaraTurkey
  2. 2.Division of Surgical Oncology, Department of Surgery, Magee-Womens Hospital of University of Pittsburgh Medical Center, School of MedicineUniversity of PittsburghPittsburghUSA

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