Incidence and Prevalence of Lymphedema After Breast Cancer Surgery: Literature Review

Abstract

Introduction: Lymphedema is one of the main complications of breast cancer surgery. Comparison of lymphedema incidence and prevalence rates is difficult, since it depends on diagnostic and inclusion criteria and the duration of follow-up. Objective: The aim of this literature review, based on epidemiological studies, was to verify the incidence and prevalence of lymphedema following breast cancer surgery, discussing the various study methodologies. Methods: This was a systematic literature review, including case-control, cross-sectional, and prospective and retrospective cohort studies. Studies were included in which the diagnosis of lymphedema was made less than six months after surgery. Results: Twenty cross-sectional and 10 cohort studies were identified that met the established selection criteria for this review (January 2000-April 2006). Lymphedema prevalence in the population submitted to axillary lymph node dissection for breast cancer ranged from 6% to 49% and incidence from 0% to 22%, depending on the diagnostic criteria, definition of lymphedema, post-surgical follow-up time, and study population characteristics. Conclusion: Differences in designs and methodologies used by authors hinder comparison of the study results. Incidence studies should be prioritized, and the definition of standardized diagnostic criteria and classification of lymphedema following breast cancer surgery is fundamental for the comparison of the different study populations.