Patients’ Concern Regarding Lymphedema Development Is Greater Than Calculated Risk

Extent of axillary surgery significant risk factor for lymphedema

A new study suggests that the majority of women who undergo breast cancer operations involving axillary lymph node removal experience anxiety related to the possible development of lymphedema, yet the patients’ fear exceeds the actual risk of the condition developing.

The study involved 120 women between the ages of 52 and 68 years, whom Mayo Clinic researchers followed over the course of 12 months. Sixty-seven women had sentinel lymph node biopsy (SLNB), and 53 underwent axillary lymph node dissection (ALND). All of the women were seen postoperatively at 1, 6, and 12 months and completed questionnaires regarding their lymphedema risk reduction behaviors and their anxiety over the condition developing.

Researchers discovered that 52% of the women who had SLNB and 75% of women who underwent ALND expressed fear about developing lymphedema. However, study results showed that of those who had SLNB, only 3% actually experienced lymphedema; among patients who underwent ALND, 19% developed lymphedema.

Furthermore, at 12 months after surgery, researchers determined that neither weight, type of breast operation (breast-conserving or mastectomy), nor radiation increased the risk for lymphedema. Instead, the results showed that the only significant factor to increase the risk of developing lymphedema was the extent of axillary surgery.

“This is the first step to quantify the problem. The aim is to educate not just patients but providers about what we really need to do, which is to better stratify patients in terms of what their true risk really is,” said lead study author Sarah McLaughlin, MD, FACS, assistant professor of surgery at the Mayo Clinic in Jacksonville, FL.

The study is published in the March issue of the Journal of the American College of Surgeons.

Source: ACS.