Incidence and risk factors of breast cancer lymphoedema

Aim. The purpose of this study was to examine the incidence of lymphoedema and to identify risk factors of lymphoedema in patients with breast cancer undergoing mastectomy in Korea. Background. Lymphoedema is a serious problem for many breast cancer survivors. Although the potential impact of lymphoedema is extensive, it is largely unrecognised. Methods. Women with breast cancer (n = 450) receiving mastectomy were recruited from outpatient breast cancer clinics of two university hospitals in Seoul, Korea from October 2004 to May 2005. Lymphoedema was defined by circumferential measurement. This study examined the risk factors associated with lymphoedema through the literature review. A descriptive design was used for this study and data were collected using structured questionnaire. Data were analysed by chi-square test and multiple logistic regression. Results. Among the 450 cases of breast cancer, 24.9% had developed lymphoedema. There were significantly increased risks of lymphoedema if women were with higher staging, had modified radical mastectomy, had axillary lymph node dissection, received axillary radiotherapy and were with body mass index greater than 25 kg/m(2). A significantly decreased risk of lymphoedema was found in women who exercised regularly, received pretreatment education of lymphoedema and had performed preventive self-care activities. Conclusions. Lymphoedema is recognised as an unpleasant and uncomfortable consequence of breast cancer-related treatment. Patients should be advised of the risk of lymphoedema and educated to detect its symptoms. Relevance to clinical practice. It is of importance to recognise breast cancer patients at risk for lymphoedema. Nurses should inform patients with breast cancer about their risk for lymphoedema and guidelines to reduce the risk and to emphasise self-care activities for prevention.