What rates of breast (not arm) lymphedema would you quote to patients post-lumpectomy and adjuvant radiation?
What prophylactic strategies you use to mitigate the risk?
Answer from: Radiation Oncologist at Academic Institution
The UK trials report on breast edema and provide helpful numbers for counseling patients. For instance, in the UK IMPORT HIGH trial (hot off the press!), rates of breast edema in the sequential boost arm (40 Gy + 16 Gy boost) were 90% none, 7% mild, 2% moderate and <1% marked. In the lower SIB ar...
Answer from: Radiation Oncologist at Community Practice
It’s underreported and under-assessed and is different based on breast size, fractionation, and the volume of treatment. In practice, favor early intervention with physical therapy.
Comments
Radiation Oncologist at Community Health Network I don’t think there are any data on breast s...
Answer from: Radiation Oncologist at Community Practice
In our practice, it seems very patient-specific. This complication is dependent on the surgical approach, scar length, and orientation, the frequent development of post-op seromas, and the extent of the nodal resection. The surgery combined with the impact of the dose, fields, and techniques of RT.
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Answer from: Radiation Oncologist at Community Practice
I agree, edema is vastly underreported. Many patients, though only “mildly” affected, still struggle with comfort and “invest” considerable time and money in finding comfortable and functionable bras and support. We refer women to local custom lingerie shops, and many benefit...
Answer from: Radiation Oncologist at Community Practice
I see clinically evident breast edema in more than 90% of patients 1 month after conclusion of breast RT. I advise intervention by the patient herself, in terms of nightly massage with a moderate degree of pressure (whatever the patient can tolerate). Most often it is resolved in 3-6 months. Makes m...