Incidence of breast carcinoma-related lymphedema

BACKGROUND: Of the 2 million breast carcinoma survivors, perhaps 15-20% are living currently with posttreatment lymphedema. Along with the physical discomfort and disfigurement, patients with lymphedema also must cope with the distress derived from these symptoms. METHODS: To review the medical literature for the question of lymphedema incidence, a comprehensive, computerized search was performed. All publications with subject headings designating breast carcinoma-related lymphedema from 1970 to the present (116 reports) were found, and each summary or abstract was read. Of the 116 reports, 35 discussed the incidence of lymphedema. Of these, seven reports since 1990 from five countries with the most relevance to current patients were then chosen for greater analysis and comparison. RESULTS: The incidence of lymphedema ranged from 6% to 30%. The source of patients, length of follow-up, measurement techniques, and definition of lymphedema varied from report to report. In general, reports with shorter follow-up reported lower incidences of lymphedema. CONCLUSIONS: The definitive study to determine the incidence of lymphedema has not been performed to date. There has been no prospective study in which patients have been followed at intervals with accurate measurement techniques over the long term.