Incidence and risk factors of lymphedema in women undergoing mastectomy, with or without breast reconstruction

Abstract

Introduction: Lymphedema is one of the main complications from the treatment of breast cancer. Objective: The aim of this study is to assess the incidence and risk factors for the development of lymphedema in mastectomized women, with or without breast reconstruction. Methods: Cohort study in women subjected to mastectomy at Hospital do Câncer III/INCA. The patients were monitored for a long period of segment. Variables related to the treatments performed were collected. Results: Women subjected to mastectomy were included in the study. In total, 94 women were subjected to breast reconstruction, with 47 (7.6%) being immediate and 47 (8.2%) late reconstructions. Lymphedema incidence in the total population was 32.8%. The lymphedema was developed on average 94.94 months after the surgical treatment. Among those submitted to reconstruction, 25 developed lymphedema, on average, 93.37 months after the surgical procedure. On the other hand, on women not submitted to reconstruction, 179 presented lymphedema, on average, after 105.95 months (p=0.035). In the Cox regression analysis, women submitted to breast reconstruction had 36%
lower risk of evolution to lymphedema in relation to the ones not subjected to this surgery (HR=0.64, CI 96%, 0.42 - 0.98, p=0.038). After staging adjustment, there was a reduction in the risk of lymphedema in 32%, despite not presenting statistical significance (HR=0.68, CI 95%, 0.45 - 1.04, p=0.073) Conclusion: Women performing breast reconstruction presented lower chance of developing lymphedema than those not having the surgery.