J.Jpn. Surg. Soc.. 82(5): 456-460, 1981

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Original article

CLINICAL STUDIES ON LYMPHEDEMA AND THE FUNCTION OF THE ARM FOLLOWING MASTECTOMY

Seven hundred and seventy three out-patients who had been at post-operative stages from 3 months to 25 years after mastectomy for breast cancer were questionaired as to complaints primarily concerning lymphedema and the dysfunction of the arm. Symptoms claimed by these patients were as follows: upper limb lymphedema in 35% of the patients, limited motions of the arm in 12%, pain and numb of the arm in 12%, and daily working troubles in 17%. Assessment of the results led to the following clinical suggestions:
1) Age: The postoperative function of the arm was little impaired in patients younger than 40 years of age at the time of operation, while it was increasingly limited with advancing age in the case of patients older than 40 years, suggesting age in the case of patients older than 40 years, suggesting the need of thorough rehabilitations. No correlation was found between the age of patients and the development of lymphedema.
2) Operation method: As the incidences of lymphedema and limited arm-movements were dependent upon the extensiveness of surgical operation, mastectomy should be performed on a small scale as long as it is expected to be satisfactorily curative.
3) Stage: Higher incidences of edema and the limitation of arm-movements were observed in patients with advanced breast cancer.
4) Postoperative irradiation: The development of edema was more frequent in irradiated patients than in those without irradiation, whereas the incidence of arm-movement limitations was unrelated to the experience of postoperative irradiation.
5) Obesity: Obese patients suffered from edema and the limitation of arm-movements more frequently than patients with normal weights.
6) Postoperative complications: The development of postoperative complications such as subcutaneous lymph retension, marginal necrosis of the skin, etc. was unrelated to the appearance of edema or the limitation of arm-movements.
It was concluded that patients with the above mentioned factors, i.e., 1)-5), must be operated with great cautions and should receive thorough postoperative treatments for preventing the development of edema and the limitation of arm-movements.

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