Lymphoedema in breast cancer

Following axillary dissection and/or irradiation a woman may experience lymphoedema of the arm. Lymphoedema can occur at any stage, even years after treatment, and can have a significant impact on both physical and psychosocial wellbeing. The predisposing factors to the development of lymphoedema remain poorly understood. Several studies have investigated age
as a risk factor and while some have reported a positive association between lymphoedema risk and older age, others have found no association.95 Lymphoedema may be more prevalent in overweight or obese women, although evidence to support this association is also inconsistent.95 Although sentinel node biopsy has been shown to be an accurate predictor of axillary node metastasis in women with small breast cancer96, the outcomes of clinical trials investigating mortality and morbidity in the long term are unknown. In Australia a clinical trial is currently under way to determine if sentinel node biopsy can avoid the need for axillary dissection in some women and reduce the risk of lymphoedema (Sentinel Node Axillary Clearance [SNAC] trial).