Online Tool May Help Predict Lymphedema Risk

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Lymphedema is swelling of the arm, hand, trunk, or breast caused by a build-up of lymph fluid in those tissues after breast cancer surgery. Edema is the medical term for swelling. Lymphedema can develop very soon after surgery or months, or even years, later.

Results from a study presented at the Multidisciplinary Breast Cancer Symposium in September 2011 suggest that an online tool does a good job of predicting the risk of lymphedema after surgery to remove breast cancer. The tool analyzes a number of lymphedema risk factors, including age and number of lymph nodes removed. When the tool was used before surgery, more than 70% of the women it predicted would develop lymphedema did develop the condition. When the tool was used after surgery, it also helped predict whether lymphedema would develop.

Lymph fluid normally drains from body tissues through the lymph nodes and lymph channels. If some lymph nodes and channels are removed or cut during surgery, lymph fluid may not drain properly and can collect in the tissues near the surgery site. The more lymph nodes that are removed, the greater the risk of lymphedema. Some research suggests that the risk of lymphedema is higher and any lymphedema that does develop is more severe in women who are overweight or obese. Radiation therapy and chemotherapy can increase the risk of lymphedema.

In this study, 1,054 Brazilian women diagnosed with early-stage breast cancer had surgery and axillary (underarm) lymph node dissection. The researchers used the online lymphedema risk tool:

  • before surgery
  • 6 months after surgery
  • more than 6 months after surgery

with all the women to predict whether they would develop lymphedema and then followed the women for 5 years. At the end of 5 years, 30.3% of the women developed lymphedema.

The tool, developed in collaboration with The Cleveland Clinic, considers a number of factors including:

  • age
  • body mass index (BMI), which includes both weight and height
  • the number of cycles of chemotherapy administered through the arm on the same side as the breast surgery
  • the number of lymph nodes removed during surgery
  • the extent of radiation therapy

Both before and after surgery, when the tool predicted that lymphedema would develop, it did more than 70% of the time.

Experts think that the tool could help doctors identify and better advise women who are much more likely to develop lymphedema after breast cancer surgery. These women could be given more information on what to do to minimize the risk of lymphedema developing, as well as to minimize the severity if lymphedema does develop.

After the researchers publish their findings in a medical journal, doctors and patients will be able to access the online tool at

If you're going to have breast cancer surgery, be sure to ask your doctor about your risk of lymphedema and the steps you can take to lower that risk. Ask your doctor if using the online tool makes sense for you. If you've already had surgery and have been diagnosed with lymphedema, visit the section on Lymphedema for more information.

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