THE SHADOW OF CURE: IMPACT OF AXILLARY LYMPH NODE DISSECTION AND ADJUVANT RADIOTHERAPY ON DEVELOPMENT OF LYMPHOEDEMA AMONG BREAST CANCER PATIENTS IN NORTHERN SRI LANKA dr.s.rajendra@gmail.com

PW04-15

THE SHADOW OF CURE: IMPACT OF AXILLARY LYMPH NODE DISSECTION AND ADJUVANT RADIOTHERAPY ON DEVELOPMENT OF LYMPHOEDEMA AMONG BREAST CANCER PATIENTS IN NORTHERN SRI LANKA

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Paramanathan Shathana shathana1991@yahoo.com University of Jaffna Department of Surgery Jaffna Sri Lanka

 

 

 

Sri Lanka

Oral or Poster

Lymphoedema is a likely complication following axillary lymph node dissection (ALND) for breast cancer. The interplay between ALND, radiotherapy, and postoperative lymphatic dysfunction is not well studied in Sri Lanka. The aim of the study was to evaluate the association between axillary lymph node status, adjuvant radiotherapy, and the development of post-ALND lymphoedema in breast cancer patients.

A retrospective cohort study was conducted among 248 followed up breast cancer patients after ALND, at a cancer referral centre in Northern Sri Lanka. Lymphoedema was defined as ≥2 cm difference in mid-arm circumferences and was assessed at least six months postoperatively. Data were analysed using the Mann–Whitney U test, Chi-square test, Fisher’s exact test with Monte Carlo simulation, and multivariate binary logistic regression to evaluate associations between clinical variables, radiotherapy field configurations, and lymphoedema. Statistical significance was set at p < 0.05.

The prevalence of lymphoedema was 23.8% (n = 59). Patients with lymphoedema had higher numbers of lymph node removal (median = 15.0; IQR: 12–20; p = 0.022). No significant association was found with nodal positivity (p = 0.344) or with radiotherapy status (p = 0.697). Multivariate analysis showed a non-significant trend with lymph node count (OR = 1.044; p = 0.056). Radiotherapy was not significantly associated with lymphoedema (p = 0.727). Rate occurrence of lymphoedema was high with radiation to chest wall and supraclavicular fossa (30.4%).

These findings underscore the need for further studies in larger cohorts to reconsider the extent of axillary dissection and radiotherapy planning.