Thesis (M.Sc.) - Cairo University - Faculty of Medicine - Department of Clinical (Oncology)

Arm lymphedema is common complication of breast cancer treatment which once established cannot be cured. All woen whohave had surgical resection of the lymph channels are at risk for lymphedema(Ottini et al.2010). In Halsted's time, lymphedema occurred in up to 62% of patients. Few recent trials of modern therapies have addressed this problem. However little is known about lymphedema among Egyptian ladies who are having breast cancer. The aim of our study is to study the risk factors and assessment of effect of lymphedema in quality of life among breast cancer patients. The study was held in department of clinical oncology Kasr Alainy school of medicine included 102 Egyptian female breast cancer patients who attended our outpatient clinic whom had previous breast surgery either modified radical mastectomy or conservative breast surgery 65 of them were having ipsilateral arm lymphedema and 37 were with no lymphedema. Lymphedema was assessed clinically by our staff members in the clinic then by examination through arm circumference measurement at four certain points on both upper limbs then calculating the average inter-limb circumference discrepancy (AICD) of >5%. Lymphedema graded into three grades based on AICD into Grade 1,2,3 with difference 5%,10%,30% accordingly. Then assessment of 24 possible risk factors which were personal, disease an treatment related. Also assessment of QOL by FACT-B questionnaire. According to definition and grading of arm lymphedema 60% of included cases had lymphedema grade1 20%, grade2 32% , grade3 9% of total number of patients. There were several risk factors that correlate significantly with lymhedema as age, BMI, presence of DVT, previous trauma, poor mobility, bad nail hygiene, arm infection, radiodermatitis and fibrosis. Also, lymphedema had direct effect in quality of life the physical well-being subscale of FACT-B is significantly lower in lymphedema patients, the emotional well-being subscale is significantly lower in lymphedema patients, the breast cancer subscale is lower in lymphedema patients and the FACT-B trial outcome index is significantly lower in lymphedema patients.

Issued also as CD