Lymphedema in Breast Cancer Survivors: Incidence, Degree, Time Course, Treatment, and Symptoms
Identifieur interne : 001839 ( Pmc/Curation ); précédent : 001838; suivant : 001840Lymphedema in Breast Cancer Survivors: Incidence, Degree, Time Course, Treatment, and Symptoms
Auteurs : Sandra A. Norman [États-Unis] ; A. Russell Localio [États-Unis] ; Sheryl L. Potashnik [États-Unis] ; Heather A. Simoes Torpey [États-Unis] ; Michael J. Kallan [États-Unis] ; Anita L. Weber [États-Unis] ; Linda T. Miller [États-Unis] ; Angela Demichele [États-Unis] ; Lawrence J. Solin [États-Unis]Source :
- Journal of Clinical Oncology [ 0732-183X ] ; 2009.
Abstract
To examine the incidence, degree, time course, treatment, and symptoms of lymphedema in breast cancer survivors.
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.
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% CI, 4.26 to 12.76).
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.
Url:
DOI: 10.1200/JCO.2008.17.9291
PubMed: 19064976
PubMed Central: 2645852
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<author><name sortKey="Norman, Sandra A" sort="Norman, Sandra A" uniqKey="Norman S" first="Sandra A." last="Norman">Sandra A. Norman</name>
<affiliation wicri:level="2"><nlm:aff id="aff0">From the Center for Clinical Epidemiology and Biostatistics; Department of Medicine, Division of Hematology/Oncology; Department of Radiation Oncology; Department of Biostatistics and Epidemiology, University of Pennsylvania School of Medicine, Philadelphia, PA; and Breast Cancer Physical Therapy Center, Cherry Hill, NJ</nlm:aff>
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<placeName><region type="state">New Jersey</region>
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<country xml:lang="fr">États-Unis</country>
<placeName><region type="state">New Jersey</region>
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<wicri:cityArea>From the Center for Clinical Epidemiology and Biostatistics; Department of Medicine, Division of Hematology/Oncology; Department of Radiation Oncology; Department of Biostatistics and Epidemiology, University of Pennsylvania School of Medicine, Philadelphia, PA; and Breast Cancer Physical Therapy Center, Cherry Hill</wicri:cityArea>
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<wicri:cityArea>From the Center for Clinical Epidemiology and Biostatistics; Department of Medicine, Division of Hematology/Oncology; Department of Radiation Oncology; Department of Biostatistics and Epidemiology, University of Pennsylvania School of Medicine, Philadelphia, PA; and Breast Cancer Physical Therapy Center, Cherry Hill</wicri:cityArea>
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<country xml:lang="fr">États-Unis</country>
<placeName><region type="state">New Jersey</region>
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<affiliation wicri:level="2"><nlm:aff id="aff0">From the Center for Clinical Epidemiology and Biostatistics; Department of Medicine, Division of Hematology/Oncology; Department of Radiation Oncology; Department of Biostatistics and Epidemiology, University of Pennsylvania School of Medicine, Philadelphia, PA; and Breast Cancer Physical Therapy Center, Cherry Hill, NJ</nlm:aff>
<country xml:lang="fr">États-Unis</country>
<placeName><region type="state">New Jersey</region>
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<wicri:cityArea>From the Center for Clinical Epidemiology and Biostatistics; Department of Medicine, Division of Hematology/Oncology; Department of Radiation Oncology; Department of Biostatistics and Epidemiology, University of Pennsylvania School of Medicine, Philadelphia, PA; and Breast Cancer Physical Therapy Center, Cherry Hill</wicri:cityArea>
</affiliation>
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<author><name sortKey="Simoes Torpey, Heather A" sort="Simoes Torpey, Heather A" uniqKey="Simoes Torpey H" first="Heather A." last="Simoes Torpey">Heather A. Simoes Torpey</name>
<affiliation wicri:level="2"><nlm:aff id="aff0">From the Center for Clinical Epidemiology and Biostatistics; Department of Medicine, Division of Hematology/Oncology; Department of Radiation Oncology; Department of Biostatistics and Epidemiology, University of Pennsylvania School of Medicine, Philadelphia, PA; and Breast Cancer Physical Therapy Center, Cherry Hill, NJ</nlm:aff>
<country xml:lang="fr">États-Unis</country>
<placeName><region type="state">New Jersey</region>
</placeName>
<wicri:cityArea>From the Center for Clinical Epidemiology and Biostatistics; Department of Medicine, Division of Hematology/Oncology; Department of Radiation Oncology; Department of Biostatistics and Epidemiology, University of Pennsylvania School of Medicine, Philadelphia, PA; and Breast Cancer Physical Therapy Center, Cherry Hill</wicri:cityArea>
</affiliation>
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<author><name sortKey="Kallan, Michael J" sort="Kallan, Michael J" uniqKey="Kallan M" first="Michael J." last="Kallan">Michael J. Kallan</name>
<affiliation wicri:level="2"><nlm:aff id="aff0">From the Center for Clinical Epidemiology and Biostatistics; Department of Medicine, Division of Hematology/Oncology; Department of Radiation Oncology; Department of Biostatistics and Epidemiology, University of Pennsylvania School of Medicine, Philadelphia, PA; and Breast Cancer Physical Therapy Center, Cherry Hill, NJ</nlm:aff>
<country xml:lang="fr">États-Unis</country>
<placeName><region type="state">New Jersey</region>
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</affiliation>
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<author><name sortKey="Weber, Anita L" sort="Weber, Anita L" uniqKey="Weber A" first="Anita L." last="Weber">Anita L. Weber</name>
<affiliation wicri:level="2"><nlm:aff id="aff0">From the Center for Clinical Epidemiology and Biostatistics; Department of Medicine, Division of Hematology/Oncology; Department of Radiation Oncology; Department of Biostatistics and Epidemiology, University of Pennsylvania School of Medicine, Philadelphia, PA; and Breast Cancer Physical Therapy Center, Cherry Hill, NJ</nlm:aff>
<country xml:lang="fr">États-Unis</country>
<placeName><region type="state">New Jersey</region>
</placeName>
<wicri:cityArea>From the Center for Clinical Epidemiology and Biostatistics; Department of Medicine, Division of Hematology/Oncology; Department of Radiation Oncology; Department of Biostatistics and Epidemiology, University of Pennsylvania School of Medicine, Philadelphia, PA; and Breast Cancer Physical Therapy Center, Cherry Hill</wicri:cityArea>
</affiliation>
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<author><name sortKey="Miller, Linda T" sort="Miller, Linda T" uniqKey="Miller L" first="Linda T." last="Miller">Linda T. Miller</name>
<affiliation wicri:level="2"><nlm:aff id="aff0">From the Center for Clinical Epidemiology and Biostatistics; Department of Medicine, Division of Hematology/Oncology; Department of Radiation Oncology; Department of Biostatistics and Epidemiology, University of Pennsylvania School of Medicine, Philadelphia, PA; and Breast Cancer Physical Therapy Center, Cherry Hill, NJ</nlm:aff>
<country xml:lang="fr">États-Unis</country>
<placeName><region type="state">New Jersey</region>
</placeName>
<wicri:cityArea>From the Center for Clinical Epidemiology and Biostatistics; Department of Medicine, Division of Hematology/Oncology; Department of Radiation Oncology; Department of Biostatistics and Epidemiology, University of Pennsylvania School of Medicine, Philadelphia, PA; and Breast Cancer Physical Therapy Center, Cherry Hill</wicri:cityArea>
</affiliation>
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<author><name sortKey="Demichele, Angela" sort="Demichele, Angela" uniqKey="Demichele A" first="Angela" last="Demichele">Angela Demichele</name>
<affiliation wicri:level="2"><nlm:aff id="aff0">From the Center for Clinical Epidemiology and Biostatistics; Department of Medicine, Division of Hematology/Oncology; Department of Radiation Oncology; Department of Biostatistics and Epidemiology, University of Pennsylvania School of Medicine, Philadelphia, PA; and Breast Cancer Physical Therapy Center, Cherry Hill, NJ</nlm:aff>
<country xml:lang="fr">États-Unis</country>
<placeName><region type="state">New Jersey</region>
</placeName>
<wicri:cityArea>From the Center for Clinical Epidemiology and Biostatistics; Department of Medicine, Division of Hematology/Oncology; Department of Radiation Oncology; Department of Biostatistics and Epidemiology, University of Pennsylvania School of Medicine, Philadelphia, PA; and Breast Cancer Physical Therapy Center, Cherry Hill</wicri:cityArea>
</affiliation>
</author>
<author><name sortKey="Solin, Lawrence J" sort="Solin, Lawrence J" uniqKey="Solin L" first="Lawrence J." last="Solin">Lawrence J. Solin</name>
<affiliation wicri:level="2"><nlm:aff id="aff0">From the Center for Clinical Epidemiology and Biostatistics; Department of Medicine, Division of Hematology/Oncology; Department of Radiation Oncology; Department of Biostatistics and Epidemiology, University of Pennsylvania School of Medicine, Philadelphia, PA; and Breast Cancer Physical Therapy Center, Cherry Hill, NJ</nlm:aff>
<country xml:lang="fr">États-Unis</country>
<placeName><region type="state">New Jersey</region>
</placeName>
<wicri:cityArea>From the Center for Clinical Epidemiology and Biostatistics; Department of Medicine, Division of Hematology/Oncology; Department of Radiation Oncology; Department of Biostatistics and Epidemiology, University of Pennsylvania School of Medicine, Philadelphia, PA; and Breast Cancer Physical Therapy Center, Cherry Hill</wicri:cityArea>
</affiliation>
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<series><title level="j">Journal of Clinical Oncology</title>
<idno type="ISSN">0732-183X</idno>
<idno type="eISSN">1527-7755</idno>
<imprint><date when="2009">2009</date>
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<front><div type="abstract" xml:lang="en"><sec><title>Purpose</title>
<p>To examine the incidence, degree, time course, treatment, and symptoms of lymphedema in breast cancer survivors.</p>
</sec>
<sec><title>Methods</title>
<p>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.</p>
</sec>
<sec><title>Results</title>
<p>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% CI, 4.26 to 12.76).</p>
</sec>
<sec><title>Conclusion</title>
<p>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.</p>
</sec>
</div>
</front>
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<front><journal-meta><journal-id journal-id-type="nlm-ta">J Clin Oncol</journal-id>
<journal-id journal-id-type="publisher-id">jco</journal-id>
<journal-title>Journal of Clinical Oncology</journal-title>
<issn pub-type="ppub">0732-183X</issn>
<issn pub-type="epub">1527-7755</issn>
<publisher><publisher-name>American Society of Clinical Oncology</publisher-name>
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<article-meta><article-id pub-id-type="pmid">19064976</article-id>
<article-id pub-id-type="pmc">2645852</article-id>
<article-id pub-id-type="publisher-id">79291</article-id>
<article-id pub-id-type="doi">10.1200/JCO.2008.17.9291</article-id>
<article-categories><subj-group subj-group-type="heading"><subject>Epidemiology</subject>
</subj-group>
</article-categories>
<title-group><article-title>Lymphedema in Breast Cancer Survivors: Incidence, Degree, Time Course, Treatment, and Symptoms</article-title>
</title-group>
<contrib-group><contrib contrib-type="author"><name><surname>Norman</surname>
<given-names>Sandra A.</given-names>
</name>
<xref ref-type="aff" rid="aff0"></xref>
</contrib>
<contrib contrib-type="author"><name><surname>Localio</surname>
<given-names>A. Russell</given-names>
</name>
<xref ref-type="aff" rid="aff0"></xref>
</contrib>
<contrib contrib-type="author"><name><surname>Potashnik</surname>
<given-names>Sheryl L.</given-names>
</name>
<xref ref-type="aff" rid="aff0"></xref>
</contrib>
<contrib contrib-type="author"><name><surname>Simoes Torpey</surname>
<given-names>Heather A.</given-names>
</name>
<xref ref-type="aff" rid="aff0"></xref>
</contrib>
<contrib contrib-type="author"><name><surname>Kallan</surname>
<given-names>Michael J.</given-names>
</name>
<xref ref-type="aff" rid="aff0"></xref>
</contrib>
<contrib contrib-type="author"><name><surname>Weber</surname>
<given-names>Anita L.</given-names>
</name>
<xref ref-type="aff" rid="aff0"></xref>
</contrib>
<contrib contrib-type="author"><name><surname>Miller</surname>
<given-names>Linda T.</given-names>
</name>
<xref ref-type="aff" rid="aff0"></xref>
</contrib>
<contrib contrib-type="author"><name><surname>DeMichele</surname>
<given-names>Angela</given-names>
</name>
<xref ref-type="aff" rid="aff0"></xref>
</contrib>
<contrib contrib-type="author"><name><surname>Solin</surname>
<given-names>Lawrence J.</given-names>
</name>
<xref ref-type="aff" rid="aff0"></xref>
</contrib>
</contrib-group>
<aff id="aff0">From the Center for Clinical Epidemiology and Biostatistics; Department of Medicine, Division of Hematology/Oncology; Department of Radiation Oncology; Department of Biostatistics and Epidemiology, University of Pennsylvania School of Medicine, Philadelphia, PA; and Breast Cancer Physical Therapy Center, Cherry Hill, NJ</aff>
<author-notes><fn><p>Corresponding author: Sandra A. Norman, PhD, 801 Blockley Hall, 423 Guardian Dr, University of Pennsylvania, Philadelphia, PA 19104-6021; e-mail: <email>snorman@mail.med.upenn.edu</email>
</p>
</fn>
</author-notes>
<pub-date pub-type="ppub"><day>20</day>
<month>1</month>
<year>2009</year>
</pub-date>
<pub-date pub-type="pmc-release"><day>20</day>
<month>1</month>
<year>2010</year>
</pub-date>
<pmc-comment> PMC Release delay is 12 months and 0 days and was based on the copyright element. </pmc-comment>
<volume>27</volume>
<issue>3</issue>
<fpage>390</fpage>
<lpage>397</lpage>
<history><date date-type="received"><day>30</day>
<month>4</month>
<year>2008</year>
</date>
<date date-type="accepted"><day>16</day>
<month>9</month>
<year>2008</year>
</date>
</history>
<permissions><copyright-statement>Copyright © 2009, American Society of Clinical Oncology</copyright-statement>
</permissions>
<self-uri xlink:title="pdf" xlink:href="zlj00309000390.pdf"></self-uri>
<abstract><sec><title>Purpose</title>
<p>To examine the incidence, degree, time course, treatment, and symptoms of lymphedema in breast cancer survivors.</p>
</sec>
<sec><title>Methods</title>
<p>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.</p>
</sec>
<sec><title>Results</title>
<p>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% CI, 4.26 to 12.76).</p>
</sec>
<sec><title>Conclusion</title>
<p>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.</p>
</sec>
</abstract>
</article-meta>
<notes><fn-group><fn><p>published online ahead of print at <ext-link ext-link-type="uri" xlink:href="www.jco.org">www.jco.org</ext-link>
on December 8, 2008</p>
</fn>
<fn><p>Supported by Grant No. R01 CA65422 from the National Cancer Institute and Grant No. ROG-02-259 from the American Cancer Society (S.A.N.).</p>
</fn>
<fn><p>Presented in part as abstracts and posters at the following three meetings: Cancer Survivorship: Pathways to Health after Treatment, National Cancer Institute and American Cancer Society, June 16-18, 2004, Washington, DC; Cancer Survivorship: Embracing the Future, National Cancer Institute, American Cancer Society, and Lance Armstrong Foundation, October 4-6, 2006, Bethesda, MD; and Cancer Survivorship Research: Mapping the New Challenges, American Cancer Society, National Cancer Institute, and Lance Armstrong Foundation, June 18-20, 2008, Atlanta, GA.</p>
</fn>
<fn><p>Authors’ disclosures of potential conflicts of interest and author contributions are found at the end of this article.</p>
</fn>
</fn-group>
</notes>
</front>
<floats-wrap><table-wrap position="float" id="t1"><label>Table 1.</label>
<caption><p>Study Participants Available by Year of Follow-Up and Age at Breast Cancer Diagnosis</p>
</caption>
<table frame="hsides" rules="groups"><thead><tr><th colspan="1" rowspan="2" align="center" valign="bottom">Year of Follow-Up</th>
<th colspan="2" rowspan="1" align="center" valign="bottom">Age < 50 Years (n = 199)
<hr></hr>
</th>
<th colspan="2" rowspan="1" align="center" valign="bottom">Age 50-79 Years (n = 366)
<hr></hr>
</th>
<th colspan="2" rowspan="1" align="center" valign="bottom">Age 80+ Years (n = 84)
<hr></hr>
</th>
<th colspan="2" rowspan="1" align="center" valign="bottom">All Participants (N = 649)
<hr></hr>
</th>
</tr>
<tr><th colspan="1" rowspan="1" align="center" valign="bottom">No. of Participants</th>
<th colspan="1" rowspan="1" align="center" valign="bottom">%</th>
<th colspan="1" rowspan="1" align="center" valign="bottom">No. of Participants</th>
<th colspan="1" rowspan="1" align="center" valign="bottom">%</th>
<th colspan="1" rowspan="1" align="center" valign="bottom">No. of Participants</th>
<th colspan="1" rowspan="1" align="center" valign="bottom">%</th>
<th colspan="1" rowspan="1" align="center" valign="bottom">No. of Participants</th>
<th colspan="1" rowspan="1" align="center" valign="bottom">%</th>
</tr>
</thead>
<tbody><tr><td colspan="1" rowspan="1" align="left" valign="top">Eligible at start of follow-up<xref ref-type="table-fn" rid="t1fn1">*</xref>
</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">196</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">100</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">354</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">100</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">81</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">100</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">631</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">100</td>
</tr>
<tr><td colspan="1" rowspan="1" align="left" valign="top">Start of year 2</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">181</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">92</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">338</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">95</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">77</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">95</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">596</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">94</td>
</tr>
<tr><td colspan="1" rowspan="1" align="left" valign="top">Start of year 3</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">164</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">84</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">308</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">87</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">65</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">80</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">537</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">85</td>
</tr>
<tr><td colspan="1" rowspan="1" align="left" valign="top">Start of year 4</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">138</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">70</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">256</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">72</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">39</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">48</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">433</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">69</td>
</tr>
<tr><td colspan="1" rowspan="1" align="left" valign="top">Start of year 5</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">133</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">68</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">238</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">67</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">34</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">42</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">405</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">64</td>
</tr>
<tr><td colspan="1" rowspan="1" align="left" valign="top">End of year 5</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">119</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">61</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">219</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">62</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">24</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">30</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">362</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">57</td>
</tr>
</tbody>
</table>
<table-wrap-foot><fn id="t1fn1"><label>*</label>
<p>Eighteen enrolled participants were found to be ineligible at start of follow-up because there was no unaffected comparison side and lymphedema could not be evaluated, including 17 participants who had simultaneous bilateral mastectomies at the reference date (histologic confirmation of breast cancer diagnosis) and one participant with a pre-existing size difference affecting the entire arm. Among the 631 remaining eligible study participants, an additional six participants recalled a size difference in their hand, lower arm, or upper arm that preceded their breast cancer diagnosis. Five of these six participants had pre-existing size differences in only one part. These pre-existing size differences were not used to calculate incidence of lymphedema, although these six women contributed to estimating incidence rates based on the parts of the arm that were the same at diagnosis.</p>
</fn>
</table-wrap-foot>
</table-wrap>
<table-wrap position="float" id="t2"><label>Table 2.</label>
<caption><p>Incidence of Lymphedema by Year and Cumulative Incidence of First Occurrence of Lymphedema by Age Group at Breast Cancer Diagnosis, by All Ages Combined, and Weighted to the Breast Cancer Population of Philadelphia and Delaware Counties During 1999 to 2001</p>
</caption>
<table frame="hsides" rules="groups"><thead><tr><th colspan="1" rowspan="2" align="center" valign="bottom">Year</th>
<th colspan="3" rowspan="1" align="center" valign="bottom">Age < 50 Years
<hr></hr>
</th>
<th colspan="3" rowspan="1" align="center" valign="bottom">Age 50-79 Years
<hr></hr>
</th>
<th colspan="3" rowspan="1" align="center" valign="bottom">Age 80+ Years
<hr></hr>
</th>
<th colspan="3" rowspan="1" align="center" valign="bottom">All Patients
<hr></hr>
</th>
<th colspan="1" rowspan="2" align="center" valign="bottom">Weighted<xref ref-type="table-fn" rid="t2fn3">‡</xref>
Cumulative Incidence</th>
</tr>
<tr><th colspan="1" rowspan="1" align="center" valign="bottom">No. of New Lymphedema Diagnoses</th>
<th colspan="1" rowspan="1" align="center" valign="bottom">No. of Participants at Risk at Start of Year<xref ref-type="table-fn" rid="t2fn1">*</xref>
</th>
<th colspan="1" rowspan="1" align="center" valign="bottom">Cumulative Incidence<xref ref-type="table-fn" rid="t2fn2">†</xref>
</th>
<th colspan="1" rowspan="1" align="center" valign="bottom">No. of New Lymphedema Diagnoses</th>
<th colspan="1" rowspan="1" align="center" valign="bottom">No. of Participants at Risk at Start of Year</th>
<th colspan="1" rowspan="1" align="center" valign="bottom">Cumulative Incidence</th>
<th colspan="1" rowspan="1" align="center" valign="bottom">No. of New Lymphedema Diagnoses</th>
<th colspan="1" rowspan="1" align="center" valign="bottom">No. of Participants at Risk at Start of Year</th>
<th colspan="1" rowspan="1" align="center" valign="bottom">Cumulative Incidence</th>
<th colspan="1" rowspan="1" align="center" valign="bottom">No. of New Lymphedema Diagnoses</th>
<th colspan="1" rowspan="1" align="center" valign="bottom">No. of Participants at Risk at Start of Year</th>
<th colspan="1" rowspan="1" align="center" valign="bottom">Cumulative Incidence</th>
</tr>
</thead>
<tbody><tr><td colspan="1" rowspan="1" align="left" valign="top">Year 1</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">59</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">196</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">0.31</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">86</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">354</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">0.25</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">15</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">81</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">0.19</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">160</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">631</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">0.26</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">0.25</td>
</tr>
<tr><td colspan="1" rowspan="1" align="left" valign="top">Year 2</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">12</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">124</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">0.38</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">16</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">253</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">0.30</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">3</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">61</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">0.23</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">31</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">440</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">0.31</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">0.30</td>
</tr>
<tr><td colspan="1" rowspan="1" align="left" valign="top">Year 3</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">8</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">102</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">0.43</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">12</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">215</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">0.34</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">0</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">49</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">0.23</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">20</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">366</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">0.36</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">0.34</td>
</tr>
<tr><td colspan="1" rowspan="1" align="left" valign="top">Year 4</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">6</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">82</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">0.47</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">11</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">171</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">0.38</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">0</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">29</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">0.23</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">17</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">282</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">0.40</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">0.38</td>
</tr>
<tr><td colspan="1" rowspan="1" align="left" valign="top">Year 5</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">4</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">74</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">0.50</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">5</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">150</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">0.40</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">1</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">25</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">0.26</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">10</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">249</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">0.42</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">0.41</td>
</tr>
</tbody>
</table>
<table-wrap-foot><fn id="t2fn1"><label>*</label>
<p>Denominators are reduced by loss to follow-up and by censoring at time of first lymphedema occurrence.</p>
</fn>
<fn id="t2fn2"><label>†</label>
<p>Cumulative incidence using standard survival analysis methods.</p>
</fn>
<fn id="t2fn3"><label>‡</label>
<p>Weighted by age distribution of breast cancer population of Philadelphia and Delaware Counties.</p>
</fn>
</table-wrap-foot>
</table-wrap>
<table-wrap position="float" id="t3"><label>Table 3.</label>
<caption><p>Time Course of Lymphedema<xref ref-type="table-fn" rid="t3fn1">*</xref>
in First 3 Years of Study Among 433 Respondents With 3 Full Years of Follow-Up</p>
</caption>
<table frame="hsides" rules="groups"><thead><tr><th colspan="1" rowspan="2" align="center" valign="bottom">Lymphedema</th>
<th colspan="2" rowspan="1" align="center" valign="bottom">Respondents
<hr></hr>
</th>
<th colspan="3" rowspan="1" align="center" valign="bottom">Month of First Lymphedema
<hr></hr>
</th>
<th colspan="3" rowspan="1" align="center" valign="bottom">No. of Person-Months With Lymphedema Present
<hr></hr>
</th>
</tr>
<tr><th colspan="1" rowspan="1" align="center" valign="bottom">No.</th>
<th colspan="1" rowspan="1" align="center" valign="bottom">%</th>
<th colspan="1" rowspan="1" align="center" valign="bottom">Mean</th>
<th colspan="1" rowspan="1" align="center" valign="bottom">Median</th>
<th colspan="1" rowspan="1" align="center" valign="bottom">Range</th>
<th colspan="1" rowspan="1" align="center" valign="bottom">Mean</th>
<th colspan="1" rowspan="1" align="center" valign="bottom">Median</th>
<th colspan="1" rowspan="1" align="center" valign="bottom">Range</th>
</tr>
</thead>
<tbody><tr><td colspan="1" rowspan="1" align="left" valign="top">No lymphedema</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">283</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">65.4</td>
<td colspan="1" rowspan="1" align="center" valign="top"></td>
<td colspan="1" rowspan="1" align="center" valign="top"></td>
<td colspan="1" rowspan="1" align="center" valign="top"></td>
<td colspan="1" rowspan="1" align="center" valign="top"></td>
<td colspan="1" rowspan="1" align="center" valign="top"></td>
<td colspan="1" rowspan="1" align="center" valign="top"></td>
</tr>
<tr><td colspan="1" rowspan="1" align="left" valign="top">Any lymphedema</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">150</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">34.6</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">8.5</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">5</td>
<td colspan="1" rowspan="1" align="center" valign="top">0-33</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">17.4</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">15.5</td>
<td colspan="1" rowspan="1" align="center" valign="top">2-36</td>
</tr>
<tr><td colspan="1" rowspan="1" align="left" valign="top"> Acute mild<xref ref-type="table-fn" rid="t3fn2">†</xref>
</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">24</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">5.5</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">13.4</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">13.5</td>
<td colspan="1" rowspan="1" align="center" valign="top">2-33</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">3.6</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">3.5</td>
<td colspan="1" rowspan="1" align="center" valign="top">2-5</td>
</tr>
<tr><td colspan="1" rowspan="1" align="left" valign="top"> Chronic mild<xref ref-type="table-fn" rid="t3fn2">†</xref>
</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">20</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">4.6</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">16.5</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">18</td>
<td colspan="1" rowspan="1" align="center" valign="top">0-30</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">19.5</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">18</td>
<td colspan="1" rowspan="1" align="center" valign="top">6-36</td>
</tr>
<tr><td colspan="1" rowspan="1" align="left" valign="top"> Improving: mild → none<xref ref-type="table-fn" rid="t3fn2">†</xref>
</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">30</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">6.9</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">6.3</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">4.5</td>
<td colspan="1" rowspan="1" align="center" valign="top">0-21</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">12.6</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">11</td>
<td colspan="1" rowspan="1" align="center" valign="top">6-27</td>
</tr>
<tr><td colspan="1" rowspan="1" align="left" valign="top"> Wax/wane: mild ⇆ none<xref ref-type="table-fn" rid="t3fn2">†</xref>
</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">26</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">6.0</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">4.7</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">4</td>
<td colspan="1" rowspan="1" align="center" valign="top">0-15</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">19.0</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">18.5</td>
<td colspan="1" rowspan="1" align="center" valign="top">5-30</td>
</tr>
<tr><td colspan="1" rowspan="1" align="left" valign="top"> Acute moderate/severe</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">2</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">0.5</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">18</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">18</td>
<td colspan="1" rowspan="1" align="center" valign="top">4-32</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">4</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">4</td>
<td colspan="1" rowspan="1" align="center" valign="top">4-4</td>
</tr>
<tr><td colspan="1" rowspan="1" align="left" valign="top"> Chronic moderate/severe</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">10</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">2.3</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">9.1</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">7</td>
<td colspan="1" rowspan="1" align="center" valign="top">1-25</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">26.9</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">29</td>
<td colspan="1" rowspan="1" align="center" valign="top">11-35</td>
</tr>
<tr><td colspan="1" rowspan="1" align="left" valign="top"> Improving: moderate/severe → mild/none</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">4</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">0.9</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">2.8</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">2.5</td>
<td colspan="1" rowspan="1" align="center" valign="top">0-6</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">24.5</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">26</td>
<td colspan="1" rowspan="1" align="center" valign="top">10-36</td>
</tr>
<tr><td colspan="1" rowspan="1" align="left" valign="top"> Progressing: mild → moderate/severe</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">10</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">2.3</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">9.4</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">6.5</td>
<td colspan="1" rowspan="1" align="center" valign="top">0-27</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">26.5</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">29.5</td>
<td colspan="1" rowspan="1" align="center" valign="top">8-36</td>
</tr>
<tr><td colspan="1" rowspan="1" align="left" valign="top"> Wax/wane: moderate/severe ⇆ mild/none (regardless of initial degree)</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">24</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">5.5</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">3.3</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">2</td>
<td colspan="1" rowspan="1" align="center" valign="top">0-22</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">26.1</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">27</td>
<td colspan="1" rowspan="1" align="center" valign="top">14-35</td>
</tr>
</tbody>
</table>
<table-wrap-foot><fn id="t3fn1"><label>*</label>
<p>Any lymphedema was defined as a degree score greater than 0 and the limb on the side of surgery was larger. Mild lymphedema was defined as a degree score of 1 to 3. Moderate/severe lymphedema was defined as a degree score of 4 to 9.</p>
</fn>
<fn id="t3fn2"><label>†</label>
<p>Lymphedema did not progress beyond mild.</p>
</fn>
</table-wrap-foot>
</table-wrap>
<table-wrap position="float" id="t4"><label>Table 4.</label>
<caption><p>Treatment for Lymphedema in First 3 Years of Follow-Up Among the 150 Respondents With Any Lymphedema in the First 3 Years: Overall and by Time Course</p>
</caption>
<table frame="hsides" rules="groups"><thead><tr><th colspan="1" rowspan="2" align="center" valign="bottom">Degree of Lymphedema</th>
<th colspan="1" rowspan="2" align="center" valign="bottom">No. of Respondents With Lymphedema</th>
<th colspan="2" rowspan="1" align="center" valign="bottom">Talked to Provider
<hr></hr>
</th>
<th colspan="2" rowspan="1" align="center" valign="bottom">Received Treatment<xref ref-type="table-fn" rid="t4fn1">*</xref>
<hr></hr>
</th>
<th colspan="8" rowspan="1" align="center" valign="bottom">Treatment Intervention (No. of respondents)
<hr></hr>
</th>
</tr>
<tr><th colspan="1" rowspan="1" align="center" valign="bottom">No. of Respondents</th>
<th colspan="1" rowspan="1" align="center" valign="bottom">%</th>
<th colspan="1" rowspan="1" align="center" valign="bottom">No. of Respondents</th>
<th colspan="1" rowspan="1" align="center" valign="bottom">%</th>
<th colspan="1" rowspan="1" align="center" valign="bottom">Exercise</th>
<th colspan="1" rowspan="1" align="center" valign="bottom">Wrap</th>
<th colspan="1" rowspan="1" align="center" valign="bottom">Sleeve</th>
<th colspan="1" rowspan="1" align="center" valign="bottom">Pump</th>
<th colspan="1" rowspan="1" align="center" valign="bottom">Elevation</th>
<th colspan="1" rowspan="1" align="center" valign="bottom">Medication</th>
<th colspan="1" rowspan="1" align="center" valign="bottom">Massage</th>
<th colspan="1" rowspan="1" align="center" valign="bottom">Other</th>
</tr>
</thead>
<tbody><tr><td colspan="1" rowspan="1" align="left" valign="top">Any lymphedema</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">150</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">119</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">79.3</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">71</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">47.3</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">55</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">28</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">37</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">8</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">40</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">23</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">47</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">16</td>
</tr>
<tr><td colspan="1" rowspan="1" align="left" valign="top">Mild lymphedema</td>
<td colspan="1" rowspan="1" align="center" valign="top"></td>
<td colspan="1" rowspan="1" align="center" valign="top"></td>
<td colspan="1" rowspan="1" align="center" valign="top"></td>
<td colspan="1" rowspan="1" align="center" valign="top"></td>
<td colspan="1" rowspan="1" align="center" valign="top"></td>
<td colspan="1" rowspan="1" align="center" valign="top"></td>
<td colspan="1" rowspan="1" align="center" valign="top"></td>
<td colspan="1" rowspan="1" align="center" valign="top"></td>
<td colspan="1" rowspan="1" align="center" valign="top"></td>
<td colspan="1" rowspan="1" align="center" valign="top"></td>
<td colspan="1" rowspan="1" align="center" valign="top"></td>
<td colspan="1" rowspan="1" align="center" valign="top"></td>
<td colspan="1" rowspan="1" align="center" valign="top"></td>
</tr>
<tr><td colspan="1" rowspan="1" align="left" valign="top"> Acute mild<xref ref-type="table-fn" rid="t4fn2">†</xref>
</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">24</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">15</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">62.5</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">10</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">41.7</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">7</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">1</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">3</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">1</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">4</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">2</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">8</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">5</td>
</tr>
<tr><td colspan="1" rowspan="1" align="left" valign="top"> Chronic mild<xref ref-type="table-fn" rid="t4fn2">†</xref>
</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">20</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">13</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">65.0</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">7</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">35.0</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">1</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">2</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">4</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">0</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">3</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">2</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">3</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">0</td>
</tr>
<tr><td colspan="1" rowspan="1" align="left" valign="top"> Improving: mild → none<xref ref-type="table-fn" rid="t4fn2">†</xref>
</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">30</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">20</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">66.7</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">6</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">20.0</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">4</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">2</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">3</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">0</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">4</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">3</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">5</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">2</td>
</tr>
<tr><td colspan="1" rowspan="1" align="left" valign="top"> Wax/wane: mild ⇆ none<xref ref-type="table-fn" rid="t4fn2">†</xref>
</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">26</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">24</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">92.3</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">14</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">53.8</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">11</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">1</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">4</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">0</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">5</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">8</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">8</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">3</td>
</tr>
<tr><td colspan="1" rowspan="1" align="left" valign="top">Moderate/severe lymphedema</td>
<td colspan="1" rowspan="1" align="center" valign="top"></td>
<td colspan="1" rowspan="1" align="center" valign="top"></td>
<td colspan="1" rowspan="1" align="center" valign="top"></td>
<td colspan="1" rowspan="1" align="center" valign="top"></td>
<td colspan="1" rowspan="1" align="center" valign="top"></td>
<td colspan="1" rowspan="1" align="center" valign="top"></td>
<td colspan="1" rowspan="1" align="center" valign="top"></td>
<td colspan="1" rowspan="1" align="center" valign="top"></td>
<td colspan="1" rowspan="1" align="center" valign="top"></td>
<td colspan="1" rowspan="1" align="center" valign="top"></td>
<td colspan="1" rowspan="1" align="center" valign="top"></td>
<td colspan="1" rowspan="1" align="center" valign="top"></td>
<td colspan="1" rowspan="1" align="center" valign="top"></td>
</tr>
<tr><td colspan="1" rowspan="1" align="left" valign="top"> Acute moderate</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">2</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">2</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">100.0</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">0</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">0.0</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">0</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">0</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">0</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">0</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">0</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">0</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">0</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">0</td>
</tr>
<tr><td colspan="1" rowspan="1" align="left" valign="top"> Chronic moderate</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">10</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">9</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">90.0</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">6</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">60.0</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">5</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">3</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">3</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">1</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">5</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">1</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">5</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">0</td>
</tr>
<tr><td colspan="1" rowspan="1" align="left" valign="top"> Improving: moderate/severe → mild/none</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">4</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">4</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">100.0</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">4</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">100.0</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">4</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">2</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">3</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">1</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">4</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">1</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">1</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">2</td>
</tr>
<tr><td colspan="1" rowspan="1" align="left" valign="top"> Progressing: mild → moderate/severe</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">10</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">8</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">80.0</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">6</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">60.0</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">6</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">5</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">4</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">1</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">4</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">1</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">4</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">0</td>
</tr>
<tr><td colspan="1" rowspan="1" align="left" valign="top"> Wax/wane: moderate/severe ⇆ mild/none (regardless of initial degree)</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">24</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">24</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">100.0</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">18</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">75.0</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">17</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">12</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">13</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">4</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">11</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">5</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">13</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">4</td>
</tr>
</tbody>
</table>
<table-wrap-foot><fn id="t4fn1"><label>*</label>
<p>Respondents were asked to respond (yes/no) to a list of specific treatments. Treatments are not mutually exclusive.</p>
</fn>
<fn id="t4fn2"><label>†</label>
<p>Lymphedema did not progress beyond mild.</p>
</fn>
</table-wrap-foot>
</table-wrap>
<table-wrap position="float" id="t5"><label>Table 5.</label>
<caption><p>Symptoms in the First 3 Years by Degree of Lymphedema: Presence and Average Frequency, Severity, and Distress Among the 433 Respondents With 3 Full Years of Follow-Up</p>
</caption>
<table frame="hsides" rules="groups"><thead><tr><th colspan="1" rowspan="3" align="center" valign="bottom">Symptom</th>
<th colspan="5" rowspan="1" align="center" valign="bottom">Moderate/Severe
<hr></hr>
</th>
<th colspan="5" rowspan="1" align="center" valign="bottom">Mild
<hr></hr>
</th>
<th colspan="5" rowspan="1" align="center" valign="bottom">No Current Lymphedema
<hr></hr>
</th>
<th colspan="5" rowspan="1" align="center" valign="bottom">No Lymphedema Ever
<hr></hr>
</th>
</tr>
<tr><th colspan="2" rowspan="1" align="center" valign="bottom">Presence
<hr></hr>
</th>
<th colspan="3" rowspan="1" align="center" valign="bottom">Average Score<xref ref-type="table-fn" rid="t5fn1">*</xref>
<hr></hr>
</th>
<th colspan="2" rowspan="1" align="center" valign="bottom">Presence
<hr></hr>
</th>
<th colspan="3" rowspan="1" align="center" valign="bottom">Average Score<xref ref-type="table-fn" rid="t5fn1">*</xref>
<hr></hr>
</th>
<th colspan="2" rowspan="1" align="center" valign="bottom">Presence
<hr></hr>
</th>
<th colspan="3" rowspan="1" align="center" valign="bottom">Average Score<xref ref-type="table-fn" rid="t5fn1">*</xref>
<hr></hr>
</th>
<th colspan="2" rowspan="1" align="center" valign="bottom">Presence
<hr></hr>
</th>
<th colspan="3" rowspan="1" align="center" valign="bottom">Average Score<xref ref-type="table-fn" rid="t5fn1">*</xref>
<hr></hr>
</th>
</tr>
<tr><th colspan="1" rowspan="1" align="center" valign="bottom">No. of Person-Months</th>
<th colspan="1" rowspan="1" align="center" valign="bottom">% of Person-Months With Symptom</th>
<th colspan="1" rowspan="1" align="center" valign="bottom">Frequency<xref ref-type="table-fn" rid="t5fn2">†</xref>
</th>
<th colspan="1" rowspan="1" align="center" valign="bottom">Severity<xref ref-type="table-fn" rid="t5fn3">‡</xref>
</th>
<th colspan="1" rowspan="1" align="center" valign="bottom">Distress<xref ref-type="table-fn" rid="t5fn4">§</xref>
</th>
<th colspan="1" rowspan="1" align="center" valign="bottom">No. of Person-Months</th>
<th colspan="1" rowspan="1" align="center" valign="bottom">% of Person-Months With Symptom</th>
<th colspan="1" rowspan="1" align="center" valign="bottom">Frequency<xref ref-type="table-fn" rid="t5fn2">†</xref>
</th>
<th colspan="1" rowspan="1" align="center" valign="bottom">Severity<xref ref-type="table-fn" rid="t5fn3">‡</xref>
</th>
<th colspan="1" rowspan="1" align="center" valign="bottom">Distress<xref ref-type="table-fn" rid="t5fn4">§</xref>
</th>
<th colspan="1" rowspan="1" align="center" valign="bottom">No. of Person-Months</th>
<th colspan="1" rowspan="1" align="center" valign="bottom">% of Person-Months With Symptom</th>
<th colspan="1" rowspan="1" align="center" valign="bottom">Frequency<xref ref-type="table-fn" rid="t5fn2">†</xref>
</th>
<th colspan="1" rowspan="1" align="center" valign="bottom">Severity<xref ref-type="table-fn" rid="t5fn3">‡</xref>
</th>
<th colspan="1" rowspan="1" align="center" valign="bottom">Distress<xref ref-type="table-fn" rid="t5fn4">§</xref>
</th>
<th colspan="1" rowspan="1" align="center" valign="bottom">No. of Person-Months</th>
<th colspan="1" rowspan="1" align="center" valign="bottom">% of Person-Months With Symptom</th>
<th colspan="1" rowspan="1" align="center" valign="bottom">Frequency<xref ref-type="table-fn" rid="t5fn2">†</xref>
</th>
<th colspan="1" rowspan="1" align="center" valign="bottom">Severity<xref ref-type="table-fn" rid="t5fn3">‡</xref>
</th>
<th colspan="1" rowspan="1" align="center" valign="bottom">Distress<xref ref-type="table-fn" rid="t5fn4">§</xref>
</th>
</tr>
</thead>
<tbody><tr><td colspan="1" rowspan="1" align="left" valign="top">All 3-year completers</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">852</td>
<td colspan="1" rowspan="1" align="center" valign="top"></td>
<td colspan="1" rowspan="1" align="center" valign="top"></td>
<td colspan="1" rowspan="1" align="center" valign="top"></td>
<td colspan="1" rowspan="1" align="center" valign="top"></td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">1,764</td>
<td colspan="1" rowspan="1" align="center" valign="top"></td>
<td colspan="1" rowspan="1" align="center" valign="top"></td>
<td colspan="1" rowspan="1" align="center" valign="top"></td>
<td colspan="1" rowspan="1" align="center" valign="top"></td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">2,784</td>
<td colspan="1" rowspan="1" align="center" valign="top"></td>
<td colspan="1" rowspan="1" align="center" valign="top"></td>
<td colspan="1" rowspan="1" align="center" valign="top"></td>
<td colspan="1" rowspan="1" align="center" valign="top"></td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">10,188</td>
<td colspan="1" rowspan="1" align="center" valign="top"></td>
<td colspan="1" rowspan="1" align="center" valign="top"></td>
<td colspan="1" rowspan="1" align="center" valign="top"></td>
<td colspan="1" rowspan="1" align="center" valign="top"></td>
</tr>
<tr><td colspan="1" rowspan="1" align="left" valign="top">Jewelry too tight</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">682</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">80.0</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">3.50</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">2.66</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">2.78</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">777</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">44.0</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">2.92</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">1.95</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">1.42</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">762</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">27.4</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">2.47</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">1.82</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">1.30</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">678</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">6.7</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">2.16</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">1.69</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">1.22</td>
</tr>
<tr><td colspan="1" rowspan="1" align="left" valign="top">Clothing too tight</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">488</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">57.3</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">3.00</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">2.49</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">2.78</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">588</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">33.3</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">2.83</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">1.89</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">1.65</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">284</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">10.2</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">2.30</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">1.68</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">1.61</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">127</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">1.2</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">2.21</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">1.59</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">1.32</td>
</tr>
<tr><td colspan="1" rowspan="1" align="left" valign="top">One side was puffy</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">748</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">87.8</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">3.37</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">2.63</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">2.62</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">1,032</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">58.5</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">2.74</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">1.75</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">1.39</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">589</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">21.2</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">2.51</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">1.77</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">1.59</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">297</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">2.9</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">2.07</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">1.70</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">1.40</td>
</tr>
<tr><td colspan="1" rowspan="1" align="left" valign="top">Could not see knuckles/veins</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">474</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">55.6</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">3.35</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">2.90</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">2.83</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">252</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">14.3</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">2.65</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">2.13</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">1.57</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">146</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">5.2</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">2.73</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">2.35</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">2.31</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">21</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">0.2</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">2.81</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">2.52</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">1.52</td>
</tr>
<tr><td colspan="1" rowspan="1" align="left" valign="top">Skin felt different</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">481</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">56.5</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">3.34</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">2.67</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">2.32</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">504</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">28.6</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">2.74</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">2.10</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">1.82</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">369</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">13.3</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">2.65</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">2.08</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">1.80</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">326</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">3.2</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">2.50</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">1.89</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">1.39</td>
</tr>
<tr><td colspan="1" rowspan="1" align="left" valign="top">Skin felt tired/thick/heavy</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">692</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">81.2</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">3.12</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">2.67</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">2.69</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">857</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">48.6</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">2.55</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">2.09</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">1.96</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">858</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">30.8</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">2.67</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">2.10</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">1.94</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">1,140</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">11.2</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">2.20</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">1.83</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">1.70</td>
</tr>
<tr><td colspan="1" rowspan="1" align="left" valign="top">Pain</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">568</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">66.7</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">2.86</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">2.70</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">2.89</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">700</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">39.7</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">2.52</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">2.14</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">2.08</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">872</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">31.3</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">2.47</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">2.05</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">1.92</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">1,542</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">15.1</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">2.35</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">1.95</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">1.83</td>
</tr>
<tr><td colspan="1" rowspan="1" align="left" valign="top">Indentations in skin</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">608</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">71.4</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">3.09</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">2.60</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">2.18</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">354</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">20.1</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">2.60</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">1.89</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">1.48</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">260</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">9.3</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">2.40</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">1.99</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">1.87</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">178</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">1.7</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">1.87</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">1.58</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">1.06</td>
</tr>
<tr><td colspan="1" rowspan="1" align="left" valign="top">Swelled after exercise</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">392</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">46.0</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">3.03</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">2.55</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">2.34</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">274</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">15.5</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">2.54</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">2.09</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">1.96</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">234</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">8.4</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">2.34</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">1.84</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">2.01</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">156</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">1.5</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">2.08</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">1.57</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">1.47</td>
</tr>
<tr><td colspan="1" rowspan="1" align="left" valign="top">Difficulty writing</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">187</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">21.9</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">2.77</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">2.68</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">2.91</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">190</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">10.8</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">2.50</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">2.17</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">2.39</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">289</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">10.4</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">2.70</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">2.10</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">2.31</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">479</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">4.7</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">2.79</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">2.09</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">2.01</td>
</tr>
<tr><td colspan="1" rowspan="1" align="left" valign="top">Any symptoms</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">852</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">100.0</td>
<td colspan="1" rowspan="1" align="center" valign="top"></td>
<td colspan="1" rowspan="1" align="center" valign="top"></td>
<td colspan="1" rowspan="1" align="center" valign="top"></td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">1,485</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">84.2</td>
<td colspan="1" rowspan="1" align="center" valign="top"></td>
<td colspan="1" rowspan="1" align="center" valign="top"></td>
<td colspan="1" rowspan="1" align="center" valign="top"></td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">1,718</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">61.7</td>
<td colspan="1" rowspan="1" align="center" valign="top"></td>
<td colspan="1" rowspan="1" align="center" valign="top"></td>
<td colspan="1" rowspan="1" align="center" valign="top"></td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">2,772</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">27.2</td>
<td colspan="1" rowspan="1" align="center" valign="top"></td>
<td colspan="1" rowspan="1" align="center" valign="top"></td>
<td colspan="1" rowspan="1" align="center" valign="top"></td>
</tr>
<tr><td colspan="1" rowspan="1" align="left" valign="top">% of months with symptoms</td>
<td colspan="1" rowspan="1" align="center" valign="top"></td>
<td colspan="1" rowspan="1" align="center" valign="top"></td>
<td colspan="1" rowspan="1" align="center" valign="top"></td>
<td colspan="1" rowspan="1" align="center" valign="top"></td>
<td colspan="1" rowspan="1" align="center" valign="top"></td>
<td colspan="1" rowspan="1" align="center" valign="top"></td>
<td colspan="1" rowspan="1" align="center" valign="top"></td>
<td colspan="1" rowspan="1" align="center" valign="top"></td>
<td colspan="1" rowspan="1" align="center" valign="top"></td>
<td colspan="1" rowspan="1" align="center" valign="top"></td>
<td colspan="1" rowspan="1" align="center" valign="top"></td>
<td colspan="1" rowspan="1" align="center" valign="top"></td>
<td colspan="1" rowspan="1" align="center" valign="top"></td>
<td colspan="1" rowspan="1" align="center" valign="top"></td>
<td colspan="1" rowspan="1" align="center" valign="top"></td>
<td colspan="1" rowspan="1" align="center" valign="top"></td>
<td colspan="1" rowspan="1" align="center" valign="top"></td>
<td colspan="1" rowspan="1" align="center" valign="top"></td>
<td colspan="1" rowspan="1" align="center" valign="top"></td>
<td colspan="1" rowspan="1" align="center" valign="top"></td>
</tr>
<tr><td colspan="1" rowspan="1" align="left" valign="top"> No symptoms</td>
<td colspan="2" rowspan="1" align="center" valign="top">0.0</td>
<td colspan="1" rowspan="1" align="center" valign="top"></td>
<td colspan="1" rowspan="1" align="center" valign="top"></td>
<td colspan="1" rowspan="1" align="center" valign="top"></td>
<td colspan="2" rowspan="1" align="center" valign="top">15.8</td>
<td colspan="1" rowspan="1" align="center" valign="top"></td>
<td colspan="1" rowspan="1" align="center" valign="top"></td>
<td colspan="1" rowspan="1" align="center" valign="top"></td>
<td colspan="2" rowspan="1" align="center" valign="top">38.3</td>
<td colspan="1" rowspan="1" align="center" valign="top"></td>
<td colspan="1" rowspan="1" align="center" valign="top"></td>
<td colspan="1" rowspan="1" align="center" valign="top"></td>
<td colspan="2" rowspan="1" align="center" valign="top">72.8</td>
<td colspan="1" rowspan="1" align="center" valign="top"></td>
<td colspan="1" rowspan="1" align="center" valign="top"></td>
<td colspan="1" rowspan="1" align="center" valign="top"></td>
</tr>
<tr><td colspan="1" rowspan="1" align="left" valign="top"> 1-2 symptoms</td>
<td colspan="2" rowspan="1" align="center" valign="top">5.8</td>
<td colspan="1" rowspan="1" align="center" valign="top"></td>
<td colspan="1" rowspan="1" align="center" valign="top"></td>
<td colspan="1" rowspan="1" align="center" valign="top"></td>
<td colspan="2" rowspan="1" align="center" valign="top">29.9</td>
<td colspan="1" rowspan="1" align="center" valign="top"></td>
<td colspan="1" rowspan="1" align="center" valign="top"></td>
<td colspan="1" rowspan="1" align="center" valign="top"></td>
<td colspan="2" rowspan="1" align="center" valign="top">35.7</td>
<td colspan="1" rowspan="1" align="center" valign="top"></td>
<td colspan="1" rowspan="1" align="center" valign="top"></td>
<td colspan="1" rowspan="1" align="center" valign="top"></td>
<td colspan="2" rowspan="1" align="center" valign="top">22.0</td>
<td colspan="1" rowspan="1" align="center" valign="top"></td>
<td colspan="1" rowspan="1" align="center" valign="top"></td>
<td colspan="1" rowspan="1" align="center" valign="top"></td>
</tr>
<tr><td colspan="1" rowspan="1" align="left" valign="top"> 3-4 symptoms</td>
<td colspan="2" rowspan="1" align="center" valign="top">17.6</td>
<td colspan="1" rowspan="1" align="center" valign="top"></td>
<td colspan="1" rowspan="1" align="center" valign="top"></td>
<td colspan="1" rowspan="1" align="center" valign="top"></td>
<td colspan="2" rowspan="1" align="center" valign="top">24.0</td>
<td colspan="1" rowspan="1" align="center" valign="top"></td>
<td colspan="1" rowspan="1" align="center" valign="top"></td>
<td colspan="1" rowspan="1" align="center" valign="top"></td>
<td colspan="2" rowspan="1" align="center" valign="top">14.1</td>
<td colspan="1" rowspan="1" align="center" valign="top"></td>
<td colspan="1" rowspan="1" align="center" valign="top"></td>
<td colspan="1" rowspan="1" align="center" valign="top"></td>
<td colspan="2" rowspan="1" align="center" valign="top">4.1</td>
<td colspan="1" rowspan="1" align="center" valign="top"></td>
<td colspan="1" rowspan="1" align="center" valign="top"></td>
<td colspan="1" rowspan="1" align="center" valign="top"></td>
</tr>
<tr><td colspan="1" rowspan="1" align="left" valign="top"> 5+ symptoms</td>
<td colspan="2" rowspan="1" align="center" valign="top">76.6</td>
<td colspan="1" rowspan="1" align="center" valign="top"></td>
<td colspan="1" rowspan="1" align="center" valign="top"></td>
<td colspan="1" rowspan="1" align="center" valign="top"></td>
<td colspan="2" rowspan="1" align="center" valign="top">30.3</td>
<td colspan="1" rowspan="1" align="center" valign="top"></td>
<td colspan="1" rowspan="1" align="center" valign="top"></td>
<td colspan="1" rowspan="1" align="center" valign="top"></td>
<td colspan="2" rowspan="1" align="center" valign="top">12.0</td>
<td colspan="1" rowspan="1" align="center" valign="top"></td>
<td colspan="1" rowspan="1" align="center" valign="top"></td>
<td colspan="1" rowspan="1" align="center" valign="top"></td>
<td colspan="2" rowspan="1" align="center" valign="top">1.1</td>
<td colspan="1" rowspan="1" align="center" valign="top"></td>
<td colspan="1" rowspan="1" align="center" valign="top"></td>
<td colspan="1" rowspan="1" align="center" valign="top"></td>
</tr>
</tbody>
</table>
<table-wrap-foot><fn id="t5fn1"><label>*</label>
<p>Average calculated only with those person-months in which symptom was present.</p>
</fn>
<fn id="t5fn2"><label>†</label>
<p>Frequency: 1 = rarely, 2 = occasionally, 3 = frequently, and 4 = almost constantly.</p>
</fn>
<fn id="t5fn3"><label>‡</label>
<p>Severity: 1 = slight, 2 = moderate, 3 = severe, and 4 = very severe.</p>
</fn>
<fn id="t5fn4"><label>§</label>
<p>Distress: 0 = none, 1 = a little bit, 2 = somewhat, 3 = quite a bit, and 4 = very much.</p>
</fn>
</table-wrap-foot>
</table-wrap>
<table-wrap position="float" id="t6"><label>Table 6.</label>
<caption><p>Presence or Absence of Symptoms on the Side of Cancer Diagnosis in the Interview Period<xref ref-type="table-fn" rid="t6fn1">*</xref>
Before Onset of Lymphedema and Lymphedema Status in the Next Interview Period by Symptom</p>
</caption>
<table frame="hsides" rules="groups"><thead><tr><th colspan="1" rowspan="3" align="center" valign="bottom">Symptom</th>
<th colspan="3" rowspan="1" align="center" valign="bottom">Symptom Present
<hr></hr>
</th>
<th colspan="3" rowspan="1" align="center" valign="bottom">Symptom Absent
<hr></hr>
</th>
<th colspan="1" rowspan="3" align="center" valign="bottom">Hazard Ratio</th>
<th colspan="1" rowspan="3" align="center" valign="bottom">95% CI</th>
</tr>
<tr><th colspan="1" rowspan="2" align="center" valign="bottom">No. of Interview Periods With Symptom Present and No Lymphedema Yet</th>
<th colspan="2" rowspan="1" align="center" valign="bottom">Immediately Following Interview Periods With Lymphedema
<hr></hr>
</th>
<th colspan="1" rowspan="2" align="center" valign="bottom">No. of Interview Periods With Symptom Present and No Lymphedema Yet</th>
<th colspan="2" rowspan="1" align="center" valign="bottom">Immediately Following Interview Periods With Lymphedema
<hr></hr>
</th>
</tr>
<tr><th colspan="1" rowspan="1" align="center" valign="bottom">No.</th>
<th colspan="1" rowspan="1" align="center" valign="bottom">%</th>
<th colspan="1" rowspan="1" align="center" valign="bottom">No.</th>
<th colspan="1" rowspan="1" align="center" valign="bottom">%</th>
</tr>
</thead>
<tbody><tr><td colspan="1" rowspan="1" align="left" valign="top">Jewelry too tight</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">64</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">19</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">29.7</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">819</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">40</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">4.9</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">7.37</td>
<td colspan="1" rowspan="1" align="center" valign="top">4.26 to 12.76</td>
</tr>
<tr><td colspan="1" rowspan="1" align="left" valign="top">Clothing too tight</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">13</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">4</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">30.8</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">870</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">55</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">6.3</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">5.47</td>
<td colspan="1" rowspan="1" align="center" valign="top">1.98 to 15.10</td>
</tr>
<tr><td colspan="1" rowspan="1" align="left" valign="top">Puffiness</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">29</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">5</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">17.2</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">854</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">54</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">6.3</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">4.20</td>
<td colspan="1" rowspan="1" align="center" valign="top">1.66 to 10.62</td>
</tr>
<tr><td colspan="1" rowspan="1" align="left" valign="top">Could not see veins or knuckles in hand</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">2</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">0</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">0.0</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">881</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">59</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">6.7</td>
<td colspan="1" rowspan="1" align="center" valign="top">—<xref ref-type="table-fn" rid="t6fn2">†</xref>
</td>
<td colspan="1" rowspan="1" align="center" valign="top">—</td>
</tr>
<tr><td colspan="1" rowspan="1" align="left" valign="top">Skin felt different</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">33</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">5</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">15.2</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">850</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">54</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">6.4</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">3.12</td>
<td colspan="1" rowspan="1" align="center" valign="top">1.24 to 7.82</td>
</tr>
<tr><td colspan="1" rowspan="1" align="left" valign="top">Skin felt tired/thick/heavy</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">106</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">16</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">15.1</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">777</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">43</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">5.5</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">3.52</td>
<td colspan="1" rowspan="1" align="center" valign="top">1.97 to 6.27</td>
</tr>
<tr><td colspan="1" rowspan="1" align="left" valign="top">Pain</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">141</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">16</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">11.3</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">742</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">43</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">5.8</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">2.42</td>
<td colspan="1" rowspan="1" align="center" valign="top">1.36 to 4.32</td>
</tr>
<tr><td colspan="1" rowspan="1" align="left" valign="top">Indentations in skin</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">15</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">2</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">13.3</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">868</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">57</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">6.6</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">1.88</td>
<td colspan="1" rowspan="1" align="center" valign="top">0.46 to 7.71</td>
</tr>
<tr><td colspan="1" rowspan="1" align="left" valign="top">Swelling after exercise</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">17</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">3</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">17.6</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">866</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">56</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">6.5</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">3.45</td>
<td colspan="1" rowspan="1" align="center" valign="top">1.08 to 11.05</td>
</tr>
<tr><td colspan="1" rowspan="1" align="left" valign="top">Difficulty writing with dominant hand</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">43</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">3</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">7.0</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">423</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">24</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">5.7</td>
<td colspan="1" rowspan="1" align="char" char="." valign="top">1.35</td>
<td colspan="1" rowspan="1" align="center" valign="top">0.41 to 4.49</td>
</tr>
</tbody>
</table>
<table-wrap-foot><fn id="t6fn1"><label>*</label>
<p>Interview period is the time between month and year of the prior interview (reference date if the first interview) and current interview date.</p>
</fn>
<fn id="t6fn2"><label>†</label>
<p>Cannot calculate hazard ratio and CI because of sparse data.</p>
</fn>
</table-wrap-foot>
</table-wrap>
</floats-wrap>
</pmc>
</record>
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