Lymphedema in Breast Cancer Survivors : Incidence, Degree, Time Course, Treatment, and Symptoms
Identifieur interne : 006807 ( Main/Exploration ); précédent : 006806; suivant : 006808Lymphedema in Breast Cancer Survivors : Incidence, Degree, Time Course, Treatment, and Symptoms
Auteurs : Sandra A. Norman [États-Unis] ; A. Russell Localio ; Sheryl L. Potashnik ; Heather A. Simoes Torpey ; Michael J. Kallan ; Anita L. Weber ; Linda T. Miller ; Angela Demichele ; Lawrence J. SolinSource :
- Journal of clinical oncology [ 0732-183X ] ; 2009.
Descripteurs français
- KwdFr :
- MESH :
- anatomopathologie : Lymphoedème.
- physiopathologie : Lymphoedème.
- épidémiologie : Lymphoedème.
- Pascal (Inist)
English descriptors
- KwdEn :
- Aged, Aged, 80 and over, Breast Neoplasms (complications), Breast cancer, Cancerology, Epidemiology, Female, Humans, Incidence, Lymphedema, Lymphedema (epidemiology), Lymphedema (pathology), Lymphedema (physiopathology), Middle Aged, Prospective Studies, Surveys and Questionnaires, Survivor, Symptomatology, Treatment.
- MESH :
- complications : Breast Neoplasms.
- epidemiology : Lymphedema.
- pathology : Lymphedema.
- physiopathology : Lymphedema.
- Aged, Aged, 80 and over, Female, Humans, Middle Aged, Prospective Studies, Surveys and Questionnaires.
Abstract
Purpose To examine the incidence, degree, time course, treatment, and symptoms of lymphedema in breast cancer survivors. Methods We conducted a 5-year, population-based prospective study of 631 randomly selected Philadelphia and Delaware County, Pennsylvania female residents with incident breast cancer who were diagnosed from 1999 to 2001. Using a questionnaire previously validated against physical therapists' measurement-based clinical criteria, we assigned a score indicating the degree of lymphedema (none, mild, or moderate/severe) to each month of follow-up based on the respondent's perceived differences in hand/arm size. Standard survival analysis methods permitted maximum use of follow-up. Results Five-year cumulative incidence of lymphedema was 42 (42%) per 100 women. Among the 238 affected women, lymphedema first occurred within 2 years of diagnosis in 80% and within 3 years in 89%. Among 433 women observed for 3 years, 23% reported no more than mild lymphedema, 12% reported moderate/severe lymphedema, and 2% reported chronically moderate/severe lymphedema. Women with mild lymphedema were more than three times more likely to develop moderate/severe lymphedema than women with no lymphedema. Thirty-seven percent of women with mild lymphedema and 68% with moderate/severe lymphedema received treatment. Increasing proportions of women with increasing degree of lymphedema reported symptoms (eg, jewelry too tight, tired/thick/heavy arm). Symptoms present before the first occurrence of lymphedema were associated with a higher probability of later lymphedema (eg, hazard ratio for jewelry too tight = 7.37; 95% Cl, 4.26 to 12.76). Conclusion Lymphedema after breast cancer is common but mostly mild. Subtle differences in self-reported hand/arm size and symptoms can be early signs of progressing lymphedema.
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<term>Aged, 80 and over</term>
<term>Breast Neoplasms (complications)</term>
<term>Breast cancer</term>
<term>Cancerology</term>
<term>Epidemiology</term>
<term>Female</term>
<term>Humans</term>
<term>Incidence</term>
<term>Lymphedema</term>
<term>Lymphedema (epidemiology)</term>
<term>Lymphedema (pathology)</term>
<term>Lymphedema (physiopathology)</term>
<term>Middle Aged</term>
<term>Prospective Studies</term>
<term>Surveys and Questionnaires</term>
<term>Survivor</term>
<term>Symptomatology</term>
<term>Treatment</term>
</keywords>
<keywords scheme="KwdFr" xml:lang="fr"><term>Adulte d'âge moyen</term>
<term>Enquêtes et questionnaires</term>
<term>Femelle</term>
<term>Humains</term>
<term>Lymphoedème (anatomopathologie)</term>
<term>Lymphoedème (physiopathologie)</term>
<term>Lymphoedème (épidémiologie)</term>
<term>Sujet âgé</term>
<term>Sujet âgé de 80 ans ou plus</term>
<term>Tumeurs du sein ()</term>
<term>Études prospectives</term>
</keywords>
<keywords scheme="MESH" qualifier="anatomopathologie" xml:lang="fr"><term>Lymphoedème</term>
</keywords>
<keywords scheme="MESH" qualifier="complications" xml:lang="en"><term>Breast Neoplasms</term>
</keywords>
<keywords scheme="MESH" qualifier="epidemiology" xml:lang="en"><term>Lymphedema</term>
</keywords>
<keywords scheme="MESH" qualifier="pathology" xml:lang="en"><term>Lymphedema</term>
</keywords>
<keywords scheme="MESH" qualifier="physiopathologie" xml:lang="fr"><term>Lymphoedème</term>
</keywords>
<keywords scheme="MESH" qualifier="physiopathology" xml:lang="en"><term>Lymphedema</term>
</keywords>
<keywords scheme="MESH" qualifier="épidémiologie" xml:lang="fr"><term>Lymphoedème</term>
</keywords>
<keywords scheme="MESH" xml:lang="en"><term>Aged</term>
<term>Aged, 80 and over</term>
<term>Female</term>
<term>Humans</term>
<term>Middle Aged</term>
<term>Prospective Studies</term>
<term>Surveys and Questionnaires</term>
</keywords>
<keywords scheme="Pascal" xml:lang="fr"><term>Adulte d'âge moyen</term>
<term>Enquêtes et questionnaires</term>
<term>Femelle</term>
<term>Humains</term>
<term>Lymphoedème</term>
<term>Sujet âgé</term>
<term>Sujet âgé de 80 ans ou plus</term>
<term>Survivant</term>
<term>Incidence</term>
<term>Cancer du sein</term>
<term>Epidémiologie</term>
<term>Traitement</term>
<term>Symptomatologie</term>
<term>Cancérologie</term>
<term>Tumeurs du sein</term>
<term>Études prospectives</term>
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<front><div type="abstract" xml:lang="en">Purpose To examine the incidence, degree, time course, treatment, and symptoms of lymphedema in breast cancer survivors. Methods We conducted a 5-year, population-based prospective study of 631 randomly selected Philadelphia and Delaware County, Pennsylvania female residents with incident breast cancer who were diagnosed from 1999 to 2001. Using a questionnaire previously validated against physical therapists' measurement-based clinical criteria, we assigned a score indicating the degree of lymphedema (none, mild, or moderate/severe) to each month of follow-up based on the respondent's perceived differences in hand/arm size. Standard survival analysis methods permitted maximum use of follow-up. Results Five-year cumulative incidence of lymphedema was 42 (42%) per 100 women. Among the 238 affected women, lymphedema first occurred within 2 years of diagnosis in 80% and within 3 years in 89%. Among 433 women observed for 3 years, 23% reported no more than mild lymphedema, 12% reported moderate/severe lymphedema, and 2% reported chronically moderate/severe lymphedema. Women with mild lymphedema were more than three times more likely to develop moderate/severe lymphedema than women with no lymphedema. Thirty-seven percent of women with mild lymphedema and 68% with moderate/severe lymphedema received treatment. Increasing proportions of women with increasing degree of lymphedema reported symptoms (eg, jewelry too tight, tired/thick/heavy arm). Symptoms present before the first occurrence of lymphedema were associated with a higher probability of later lymphedema (eg, hazard ratio for jewelry too tight = 7.37; 95% Cl, 4.26 to 12.76). Conclusion Lymphedema after breast cancer is common but mostly mild. Subtle differences in self-reported hand/arm size and symptoms can be early signs of progressing lymphedema.</div>
</front>
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<name sortKey="Localio, A Russell" sort="Localio, A Russell" uniqKey="Localio A" first="A. Russell" last="Localio">A. Russell Localio</name>
<name sortKey="Miller, Linda T" sort="Miller, Linda T" uniqKey="Miller L" first="Linda T." last="Miller">Linda T. Miller</name>
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<name sortKey="Weber, Anita L" sort="Weber, Anita L" uniqKey="Weber A" first="Anita L." last="Weber">Anita L. Weber</name>
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