Early-stage breast cancer: Arm edema after wide excision and breast irradiation

PURPOSE: To determine the incidence of arm edema in women with early-stage breast cancer after breast-conserving surgery and irradiation. MATERIALS AND METHODS: Women aged 29-83 years (mean, 55.9 years) treated with breast-conserving surgery and irradiation (n = 183) underwent a series of measurements of the circumference of each arm. Patient and treatment factors were analyzed for predictive value. RESULTS: Arm edema developed in 35.0% (n = 64), and clinically significant edema developed in 17.5% (n = 32) of patients. Dissections that yielded 16 or more nodes led to a 44% actuarial incidence of edema and a 29% actuarial incidence of clinically significant edema. Clinically significant arm changes occurred in 19 of the 87 (22%) women older than 55 years and in 13 of the 96 (14%) women younger than 55 years (P =.002). Chemotherapy, breast radiation dose, and use of tamoxifen had no effect on development of edema. CONCLUSION: Axillary dissection producing more than 15 nodes and age older than 55 years are predictive of arm edema.