Source: Epilepsy Curr  |  Posted 5 years ago

By Crystal Phend

LAS VEGAS, N.V. -- May 2, 2006 -- Obesity appears to increase the risk of developing lymphedema after axillary lymph nodes are removed for breast cancer, according to a study presented here at the annual meeting of the American Society of Breast Disease (ASBD).

"Patients need to be informed of this risk," said lead author Lucy K. Helyer, MD, surgical oncology fellow, Princess Margaret Hospital University Health Network, Toronto, Ontario, Canada, in a presentation on April 28[^]th[].

In Dr. Helyer's study, increasing lymphedema rates were seen with increasing body mass index (BMI). About 36% of obese patients had the condition compared to about 16% of overweight patients, about 7% of normal weight patients and no underweight patients.

Lymphedema, chronic swelling caused by build up of lymphatic fluid, is a frequent complication of breast cancer therapy. Arm lymphedema occurs in anywhere from 6% to 62% of breast cancer patients depending on measurement methodology and follow-up time, Dr. Helyer said.

The researchers prospectively followed 137 women with breast cancer who underwent sentinel lymph node biopsy with or without axillary node dissection.

Patients' arm volumes were measured before surgery and every 6 months afterward for 24 months, and their subjective complaints of lymphedema symptoms were reviewed. All symptomatic patients were treated with arm elevation, compression sleeve and massage.

Lymphedema was defined as an arm immersion volume increase >200 mL compared to the patient's other arm. The researchers used World Health Organization definitions for BMI, with 25 to 29.2 considered overweight and 30 or more classified as obese.

Most of the patients had received lumpectomy (132) and less than half had received sentinel lymph node biopsy without axillary lymph node biopsy (54). The average number of sentinel lymph nodes removed was 3.55 and the average number of axillary lymph nodes dissected was 11.66.

Axillary lymph node dissection was associated with more arm volume change at all time points compared to sentinel lymph node biopsy alone, but this was not a significant difference.

"Symptomatic lymphedema occurs in one third of patients with objective lymphedema, often without a precipitating event," Dr. Helyer noted.

[Presentation title: Obesity is a Risk Factor for Developing Lymphedema in Breast Cancer Patients. Poster 2-6]