Incidence and Risk Factors of Arm Lymphedema Following Breast Cancer Treatment

Abstract

Background: All breast cancer patients are at risk for developing lymphedema (LE) as a complication of breast cancer surgery and radiation. The reported incidence ranges from 5%-60%. In Ghana, 50% of women with breast cancer who come to the hospital present with late-stage breast cancer. Komfo Anokye Teaching Hospital (KATH) has no available data to support LE incidence. Aim: To determine the incidence and risk factors of lymphedema after breast cancer treatment at the oncology unit of KATH, Kumasi, Ghana between 01 January 2005 to 31 December 2008. Methods: Breast cancer and lymphedema related variables were collected from the medical records of breast cancer patients. Data were analyzed using descriptive statistics and χ2 tests. Results: Among 313 patients treated for breast cancer between 2005 and 2008, 31 (9.9%) developed lymphedema after treatment. A χ2 test showed that axillary lymph node dissection was statistically a significant risk factor of lymphedema (χ2 test value = 7.055, P = 0.008). Radiation and late stage of breast cancer diagnosis may have contributed in development of lymphedema despite having P value > 0.05. Age, BMI and hypertension were also not associated with lymphedema. Conclusion: This study provides evidence that the incidence of lymphedema was 9.9% with axillary lymph node dissection as a statistically significant risk factor of lymphedema. Implication for practice: With majority of breast cancer patients presenting with late stage disease and also undergoing axillary lymph node dissection, lymphedema will continue to be a problem in Ghana. Knowing the incidence and risk factors of lymphedema not only helps in the early detection and effective management of lymphedema but also provides base-line data for further research on lymphedema in Ghana.