• 作者：H. Ben Salah^a ; ^{ben_salah_hanen@yahoo.fr} ; M. Bahri^a ; B. Jbali^a ; M. Guermazi^b ; M. Frikha^c ; J. Daoud^a
• 关键词：Lymph&oelig ; dè ; me secondaire ; Cancer du sein ; Facteurs de risque
• 刊名：Cancer Radiotherapie
• 出版年：2012
• 期刊代码：45_12783218
• 类别：med
• 出版时间：April, 2012
• 卷：16
• 期：2
• 页码：123-127
• 文件大小：361 K

Purpose

To study the frequency and risk factors for upper limb lymphedema through a series of patients treated for breast cancer.

Patients and methods

It is a retrospective study about 222 patients treated for breast cancer during the period between February 1993 and December 2003 in Sfax hospitals. Average age was 51 years (27-92 years). Tumour was T2 in 59%of cases. All patients had surgery with lymph node dissection. Infiltrating ductal carcinoma was the most frequent histological type (80%of cases), with predominant SBR II grade (62%). The mean number of removed lymph nodes was 12 (2-33). Axillary lymph node metastasis was detected in 124 patients. Radiotherapy was delivered in 200 patients, including axillary irradiation in 30 cases. The mean follow-up was 68 months (12-120).

Results

Lymphedema appeared in 23%of cases (51 patients), 14 months after surgery (mean period). Lymphedema affected the brachium in 17%of cases, the forearm in 12%of cases and all upper limb in 71%of cases. Fifty percent of patients had rehabilitation. However, improvement of lymphedema was obtained in 18 cases. Parameters predicting lymphedema were studied. Significant risk factors were obesity, infection and a number of removed lymph node above 10. The type of surgery, axillary irradiation and shoulder abduction deficit did not predict lymphedema.

Conclusion

Lymphedema of the arm is a frequent consequence of breast cancer treatment. The risk of lymphedema is correlated with obesity, infection and a number of removed lymph node above 10.