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Lymphedema in women with breast cancer: characteristics of patients screened for a randomized trial

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Abstract

Introduction

Accrual rates for a randomized trial of decongestive therapy in breast cancer patients with lymphedema were lower than anticipated. In two centres, patients presenting to lymphedema clinic were screened for eligibility to understand the accrual process and help define the patient population.

Materials and methods

All breast cancer patients presenting to two lymphedema clinics in regional cancer centres were screened for study entry. Circumferential arm measurements were taken and volumes calculated. Patients were then screened for trial eligibility. All report forms were sent to the trial coordinating centre.

Results

A total of 408 patients were screened. Median arm volume excess was 239 ml (9.5%). One third of patients had little or no excess volume. Only 28.3% of patients had sufficient excess volume for trial eligibility. Of these, a significant number of patients were excluded because of active malignancy or previous decongestive therapy.

Conclusions

The finding of moderate to severe lymphedema observed in clinics screening for trial eligibility was less than expected. The natural history of lymphedema in breast cancer patients is potentially changing. Some patients may be presenting with sensory changes suggestive of lymphedema but due to other causes, such as nerve disruption following axillary dissection.

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Author information

Authors and Affiliations

  1. Department of Oncology, McMaster University, Hamilton, Ontario, Canada

    Ian S. Dayes, Mark N. Levine & T. J. Whelan

  2. Juravinski Cancer Centre, 699 Concession Street, Hamilton, Ontario, Canada, L8V 5C2

    Ian S. Dayes, Mark N. Levine & T. J. Whelan

  3. Ontario Clinical Oncology Group, Hamilton, Ontario, Canada

    Mark N. Levine, J. A. Julian & Kathleen I. Pritchard

  4. Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, Ontario, Canada

    Mark N. Levine, J. A. Julian & T. J. Whelan

  5. Department of Medicine, University of Toronto, Toronto, Ontario, Canada

    Kathleen I. Pritchard

  6. Toronto Sunnybrook Regional Cancer Centre, Toronto, Ontario, Canada

    Kathleen I. Pritchard

  7. London Regional Cancer Centre, London, Ontario, Canada

    David P. D’Souza

  8. Department of Nursing, London Regional Cancer Centre, London, Ontario, Canada

    Lyn Kligman

  9. University of Western Ontario, London, Ontario, Canada

    David P. D’Souza

  10. Talspar Nursing Services, 249 West 32nd Street, Hamilton, Ontario, Canada, L9C 5H5

    Donnalue Reise

  11. Department of Nursing, Juravinski Cancer Centre, 699 Concession Street, Hamilton, Ontario, Canada, L8V 5C2

    Jennifer A. Wiernikowski

  12. Population Health Research Institute, McMaster University, Hamilton, Ontario, Canada

    L. Bonilla

Authors
  1. Ian S. Dayes
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  2. Mark N. Levine
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  3. J. A. Julian
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  4. Kathleen I. Pritchard
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  5. David P. D’Souza
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  6. Lyn Kligman
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  7. Donnalue Reise
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  8. Jennifer A. Wiernikowski
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  9. L. Bonilla
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  10. T. J. Whelan
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Corresponding author

Correspondence to Ian S. Dayes.

Appendix

Appendix

Calculation of arm volume.

Arm volumes were calculated based on the formula for a truncated cone:

$$ {\text{V}} = ({\text{C}}_{1}^{2} + {\text{C}}_{1} \cdot {\text{C}}_{2} + {\text{C}}_{2}^{2}) \times {\text{L}} / 12\pi $$

Where: V = Volume (ml)

C1 = Arm circumference (cm), distal extent of segment

C2 = Arm circumference (cm), proximal extent of segment

L = Length of segment (cm)

A total of 7 segments were summated to calculate arm volume.

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Dayes, I.S., Levine, M.N., Julian, J.A. et al. Lymphedema in women with breast cancer: characteristics of patients screened for a randomized trial. Breast Cancer Res Treat 110, 337–342 (2008). https://doi.org/10.1007/s10549-007-9727-0

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  • DOI: https://doi.org/10.1007/s10549-007-9727-0

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