Lymphoedema after mastectomy for breast cancer: importance of supportive care.

Background: Lymphoedema resulting from axillary lymph node dissection remains a challenging complication after modified radical mastectomy.

Objective: To examine the effects of supportive therapy such as rehabilitation and medical and physical treatment on the development of lymphoedema, in an attempt to establish non-surgical ways to help prevent or reduce it.

Methods: Patients (N=5 064) who underwent breast cancer surgery in the Department of General Surgery, Ankara Oncology Research and Training Hospital, Turkey, between 1995 and 2010 were included. Data were collected by retrospectively examining all the patients' files and the pre- and postoperative breast cancer follow-up forms.

Results: Of the patients in the study, 19.9% developed lymphoedema. It was significantly less common in patients who participated in physiotherapy than in those who did not, and it was more common in patients with a body mass index (BMI, kg/m²) between 30 and 34.9 than in patients with lower BMIs. Postoperative axillary radiotherapy did not affect the occurrence of lymphoedema.

Conclusion: It is clear that the most successful method to reduce the impact of lymphoedema is to prevent it. We believe that educating patients about the risk factors for developing lymphoedema and referring them to postoperative physical therapy and rehabilitation clinics are the most important ways to avoid this distressing condition.