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Jun 28, 2012 10:30 PM, edited Jun 28, 2012 10:43 PM
Here's a discussion that is based on a variety of studies, and the one by Shah and Vicini is actually a very well done study-of-studies (and they conclude that the apples-and-oranges problem that Kira describes makes it nearly impossible to compare studies). You can see from this discussion just how far apart the LE incidence ranges are, depending on nature of the studies:
Breast cancer treatments and BCRL risk
BCRL risk factors seem to be additive: A woman with breast conserving surgery and no other treatment has less BCRL risk than a woman receiving breast conserving surgery with axillary node dissection and radiation. Increasing the number of nodes removed also increases BCRL risk (Paskett et al)[i]. Sentinel node biopsy, which removes one to seven nodes, brings a lower risk than axillary node dissection, when 25 or more nodes might be removed.
Shah and Vicini (2011) summarized lymphedema incidence ranges with various treatments, in their BCRL-study review: [ii]
Lumpectomy alone 0-3%
Lumpectomy with SLN and breast RT 3-23%
Lumpectomy with ALND and breast RT 1-61%
Lumpectomy with regional nodal RT 9-65%
Mastectomy with SLN, no RT 3-23%
Mastectomy with ALND, no RT 30-47%
Mastectomy with regional nodal RT 58-65%
ALND with axillary RT 32%
ALND = axillary node dissection SLN=sentinel node RT=radiation therapy
Most BCRL studies focus on arm lymphedema, which is readily measured once past Stage 0, or subclinical BCRL. However, many breast cancer patients develop lymphedema of the breast or trunk, with or without arm lymphedema. One year after surgery, Ronka et al (2004) found breast edema identified by clinical examination in 48% of patients with axillary clearance/ positive nodes; in 35% with axillary clearance/ negative nodes; and in 23% with sentinel node biopsy. Using ultrasound, they found subcutaneous breast edema in 69-70% of the axillary clearance node patients and 28% of the sentinel node biopsy patients.[iii] Sentinel node biopsy reduces arm lymphedema risk compared to axillary clearance, but it poses a significant risk for breast lymphedema.
References are below--
[i] Paskett ED, Naughton MJ, McCoy TP, Case LD, Abbott JM. (2007) The epidemiology of arm and hand swelling in premenopausal breast cancer survivors. Cancer Epidemiology, Biomarkers & Prevention, 16(4): 775-782.
[ii] Shah C, Vicini FA (2011) Breast cancer-related arm lymphedema: Incidence rates, diagnostic techniques, optimal management and risk reduction strategies. International Journal of Radiation Oncology·Biology·Physics, 81(4): 907-914.
[iii] Rönkä RH, Pamilo MS, von Smitten KA, Leidenius MH. (2004) Breast lymphedema after breast conserving treatment. Acta Oncologica. 43(6):551-7.
(edited because the first post did not render the incidence-range table very well, so I retyped it without table formatting)