ABSTRACT
This study included 20 female patients who had lymphoedema following a variety of treatment for operable breast cancer .Our study was assessed in the surgical department of El Minia University Hospital from 1992 to 1997.Patients who had been followed for at least one year after breast surgery were eligible for inclusion in the study, while those with bilateral breast cancer were excluded. Lymphoedema was assessed in two ways: subjective [patient plus observer impression] and objective [physical measurement]. Arm volume measurement 15 cm above the lateral epicondyle was the most accurate method of assessing difference in size of the operated and normal arm. Arm circumference measurement were inaccurate. Subjective lymphoedema was present in 15 percent whereas objective lymphoedema [a difference in limb volume >200 ml] was present in 80 percent. Independent risk factors contributing towards the development of subjective late lymphoedema were the extent of axillary surgery [P <0.05], axillary radiotherapy [P<0.001] and pathological nodal status[P<0.10]. The risk of developing late lymphoedema was unrelated to age, menopausal status, handedness, early lymphoedema, surgical and radio therapeutic complication, total dose of radiation, time interval since presentation, drug therapy, surgery to breast, radiotherapy to the breast and tumor T stage. The incidence of subjective late lymphoedema was similar after axillary radiotherapy alone or axillary sampling plus radiotherapy [0 percent], while axillary clearance alone was [25 percent]. The incidence after axillary clearance plus radiotherapy was significantly greater [33.3 percent, P<0.001]. Axillary radiotherapy should be avoided in patient who have had a total axillary clearance