The Degree of Post-Mastectomy Upper Limb Lymphedema in Relation to the Extent of Axillary Lymph Nodes Involvement and Dissection Ahmed N Abdulnabi* CABS, Issam Merdan** FICMS CABS

Keywords: Breast cancer, Mastectomy, Lymphedema


Background: Lymphedema of the upper extremity is a serious consequence of breast cancer surgery. Postmastectomy lymphedema of the upper limb is usually related to many risk factors like axillary surgery, radiotherapy, venous obstruction, obesity, and infection.
Objectives: To identify the relationship between the extent of axillary lymph nodes involvement and dissection on the development of upper limb lymphedema.
Methods: One hundred and seventy patients managed by modified radical mastectomy with axillary dissection for mammary invasive adenocarcinoma between January 2009 and December 2016 in Al-Fayhaa Teaching Hospital. The patients were divided in to three groups according to the number of lymph nodes involvement by pathology. The patients had been followed up for a minimum of two years and assessed by standard lymphedema assessment, then categorized in to three groups according to the severity of lymphedema.
Results: After the analysis of patient parameters, the highest age group was 36-45 years. More than 60% of the patients had 4-9 lymph nodes involvement. Forty one patients from the 170 developed lymphedema postoperatively. Forty patients had seroma and twenty one patients had wound infection postoperatively.
Conclusion: Postmastectomy lymphedema is sequelae of disease process related to the extent of lymph nodes involvement and resection rather than operative fault.