A recent Australian review of lymphoedema (1) found that one in five women treated for breast cancer will experience lymphoedema but also suggested that prospective studies were needed to improve our understanding of this condition. Although there are a number of methods which have been developed to measure the presence of lymphoedema, a gold-standard method is lacking. The aim of our study was to document both the incidence and prevalence of self-reported lymphoedema between 2 and 4 years following diagnosis, factors associated with the development of lymphoedema and the impact of lymphoedema on psychological wellbeing. We used the BUPA Health Foundation Health and Wellbeing After Breast Cancer Study (2), a cohort of 1683 Victorian women treated for their first episode of invasive breast cancer. Participants completed an enrolment questionnaire within 12 months of diagnosis and then annual follow-up questionnaires thereafter. Each follow-up questionnaire included questions about the presence of lymphoedema. Psychological wellbeing was assessed using the Psychological General Wellbeing Index.
Two years after diagnosis nearly 20% of women reported lymphoedema. Although this proportion remained above 18% four years from diagnosis, self-reported lymphoedema had resolved in some women whereas 43 were reporting the onset of lymphoedema for first time 4 years from diagnosis. Lymphoedema 2 years from diagnosis was positively associated with the number of nodes removed at initial surgery, although this only explained a small proportion (7%) of the likelihood of reporting lymphoedema. The presence of lymphoedema 2 years from diagnosis was associated with lower psychological general wellbeing.
Lymphoedema following treatment for breast cancer is a dynamic condition and it may emerge as an issue for the first time in women several years after their initial treatment. The presence of lymphoedema is associated with a lower level of psychological general wellbeing.