Prevalence of lymphedema in women undergoing treatment for breast cancer in a referral center in southeastern Brazil
1 School of Medical Sciences and Health, Juiz de Fora, Brazil
2 School of Medicine, Institutional Programs for Scientific Start-up Grants (XX PIBIC/UFJF), Federal University of Juiz de Fora, Juiz de Fora, Brazil
3 School of Dentistry, Institutional Programs for Scientific Start-up Grants (XX PIBIC/UFJF), Federal University of Juiz de Fora, Juiz de Fora, Brazil
4 Public Health Department of the School of Medicine, Federal University of Juiz de Fora, Juiz de Fora, Brazil
BMC Women's Health 2013, 13:6 doi:10.1186/1472-6874-13-6Published: 13 February 2013
Lymphedema is a highly prevalent condition in women who have undergone treatment for breast cancer. Lymphedema negatively affects the quality of life. The objective of this study was to estimate the prevalence of lymphedema and associated factors in women treated for breast cancer in the municipality of Juiz de Fora.
We performed a cross-sectional study that evaluated 250 women who were being treated for breast cancer. Pre-screening of the sample by analysis of medical records was performed to select women who met the inclusion criteria as follows: women who had an operation more than 6 months ago; absence of active disease, locoregional or distant; the absence of functional change in the affected limb before surgery, which could lead to swelling of the limb; and simulating or masking symptoms of lymphedema, such as bursitis, tendonitis, and work-related musculoskeletal disorders. Women with bilateral breast cancer, absence of axillary intervention (partial or complete axillary dissection and/or SLN biopsy), active disease in the region, or lympho-venous alteration of the limb before surgery were excluded. Data were collected from the medical records of the selected cases, and they subsequently underwent an interview and a physical assessment.
The prevalence of lymphedema was 44.8%. There were medical records on the presence of this condition in 5.4% of cases. With regard to shoulder joint mobility, restrictions on abduction movements, internal and external rotation, and anterior shoulder adduction were significantly associated with lymphedema. Variables, including the presence of seroma, vascular changes, time elapsed after surgery, episodes of redness in the extremities, and cuticle removal from the hand with pliers were considered as major associated factors for lymphedema (p<0.05).
The prevalence of 44.8% for lymphedema found in this study is considered to be relevant because it is a morbidity that produces psychological, physical, and functional damage in patients with this condition. The planning of health programs and services appropriate for the immediate postoperative treatment of women with breast cancer, and increasing the awareness of health professionals regarding the early diagnosis of lymphedema, can help minimize the morbidity of this disease.