Evaluating the Effect of Axillary Lymph Node Involvement and Dissection in the Development of Post-Mastectomy Lymphedema

Abstract

Background: Lymphedema of the upper extremity is a serious consequence of breast cancer surgery. Postmastectomy lymphedema of the upper limb is usually related to many risk factors, like axillary surgery, radiotherapy, venous obstruction, obesity, and infection. In the current study, the objective was to identify the relationship between the extent of lymph node involvement and axillary dissection on the development of lymphedema. Patients and methods: One hundred and seventy patients managed by modified radical mastectomy with axillary dissection for mammary-invasive adenocarcinoma between January 2009 and December 2016 in Al-Fayhaa Teaching Hospital. The patients were divided into three groups according to the number of lymph nodes involvd, by pathology. The patients had been followed up for at least two years and assessed by standard lymphedema assessment, then categorized into three groups, according to the severity of lymphedema. Results: After the analysis of patient parameters, the highest age group was 36–45 years. More than 60% of the patients had 4–9 lymph nodes involved. Forty-one patients from the 170 developed lymphedema postoperatively. Forty patients had seroma and twenty-one patients had wound infection postoperatively. Conclusion: Post-mastectomy lymphedema is a sequelae of disease process related to the extent of lymph-node involvement and resection rather than operative fault. Key words: breast cancer, mastectomy, lymphedema.