Arm lymphoedema in a cohort of breast cancer survivors 10 years after diagnosis

Figures & data

Table I. Characteristics, lymphoedema group (n=98) at time of arm lymphoedema diagnosis and controls (n=40) at end of the study.

	Oedema group	Controls
	n=98	n=40
	mean±SD (median)	mean±SD (median)
Age, years	63.4 ±11.3 (57.0)	58.9 ± 11.4 (60)
Op site, right/left	57/41	21/19
Op side, dominant/ non dominant	60/38	20/20
Time from op to oedema diagnosis, months	11.5 ± 12.8 (9.0)
Time from op to last measurement, months	43.0 ± 32.5 (31.0)	72.6 ± 30.0 (54.5)
BMI*	25.8 ± 4.1 (25.9)	25.9 ± 4.5 (24.7)
Arm volume op, ml	2468 ± 420 (2440)	2375 ±514 (2270)
Arm volume contralateral, ml	2284 ±391 (2269)	2344 ± 504 (2294)
LAV*, ml	183.5 ± 79.1 (166)	30 ± 92 (22)
LRV*, %	8.1 ± 3.6 (7.0)	1.4 ± 4.3 (1.1)

*BMI: Body Mass Index, LAV: Lymphoedema absolute volume, LRV: Lymphoedema relative volume

Table II. Definition of the sub groups with breast cancer related arm lymphoedema.

Early BCRL was defined as arm lymphoedema diagnosed ≤12 months after operation. Patients with early BCRL had all been diagnosed within the routine follow-up.

Late BCRL was defined as arm lymphoedema diagnosed >12 months after operation. Patients with late BCRL had either contacted the Lymphoedema Unit themselves or been referred by a physician.

Small LRV was defined as LRV 5–<10.0% at time of diagnosis.

Large LRV was defined as LRV≥10.0% at time of diagnosis.

Regular treatment was defined as treatment at least twice a year with at least two compression sleeves.

Non-regular treatment was defined as treatment frequency less than twice a year or with longer intervals by the patient's choice.

Figure 1. Measurement of arm volume with water displacement method.

Figure 2. Palpation of skin and subcutaneous tissues.

Figure 3. Distribution over time of lymphoedema relative volume (LRV) at time of last measurement in patients with breast cancer related arm lymphoedema (n=98).

Table III. Lymphoedema relative volume (%) in the different year categories at time of diagnosis (start) and last measurement (end) during follow-up 1–10 years.

Follow-up,	Number of	Start mean	End mean
years	patients	LRV ± SD, %	LRV± SD, %	p-value
0	17	7.0 ± 1.9	no data
1	11	7.5 ± 2.5	5.9 ± 3.9	n.s.
2	13	9.2 ± 5.4	8.7 ± 7.4	n.s.
4	16	8.5 ± 2.9	9.8 ± 6.9	n.s.
6	19	7.6 ± 2.6	10.6 ± 9.4	n.s.
8	12	8.2 ± 2.9	12.5 ± 8.2	n.s.
10	10	9.8 ± 6.3	7.4 ± 3.1	n.s.

LRV; lymphoedema relative volume

Table IV. Lymphoedema absolute (ml) and relative volume (%) at 1, 2, 4, 6, 8 and 10 years after diagnosis of breast cancer related arm lymphoedema.

Follow-up, years	Number of patients	mean LAV ± SD, ml	mean LRV ± SD, %
start	98	183.5 ± 79.1	8.1 ± 3.6
1	70	167.7 ± 123.1	7.3 ± 5.2*
2	50	197.9 ± 171.1	8.6 ± 7.0
4	38	308.6 ± 313.9	13.4 ± 12.8*
6	28	276.4 ± 231.3	11.4 ± 9.1
8	14	271.6 ± 228.4	11.4 ± 8.0
10	10	153.7 ± 57.9	7.4 ± 3.1

LAV; lymphoedema absolute volume

LRV; lymphoedema relative volume

*p≤0.05, compared to LRV at start

Table V. Comparison of lymphoedema relative volume (LRV) by years after diagnosis of breast cancer related arm lymphoedema (LE).

Categories by years since LE diagnosis in participants with completed volume measures1	1 year mean±SD LRV%	(n)	2 years mean±SD LRV %	(n)	4 years mean±SD LRV %	(n)	6 years mean±SD LRV %	(n)
Time points of measurement comparison:
Start/1 y	8.6±4.0/7.3±5.2*	(70)	9.1±4.4/8.0±5.7	(49)	8.9±4.2/7.7±5.6	(34)	9.0±4.6/7.0±6.1	(23)
1 y/2 y	- - -		8.0±5.7/8.6±7.1	(49)	7.7±5.8/8.9±7.1	(32)	7.8±7.2/7.7±6.4	(15)
2y/4y	- - -		- - -		8.9±7.0/12.1±10.1**	(33)	7.6± 6.2/14.4 ±12.6**	(16)
4y/6y	- - -		- - -		- - -		17.4 ±16.2/12.6 ±8.8	(19)

1 No analysis was carried out for the category 8 years (n=7) and 10 years (n=2) as numbers were few.

*p≤0.05, **p≤0.01