What rates of breast (not arm) lymphedema would you quote to patients post-lumpectomy and adjuvant radiation?

The UK trials report on breast edema and provide helpful numbers for counseling patients. For instance, in the UK IMPORT HIGH trial (hot off the press!), rates of breast edema in the sequential boost arm (40 Gy + 16 Gy boost) were 90% none, 7% mild, 2% moderate and <1% marked. In the lower SIB arm (48 Gy SIB), the rates were 95% none; 4% mild; 1% moderate, and <1% marked (table A9). The rate of moderate/marked breast edema was 2.9% in the sequential boost arm and 1.5% in the SIB 48 Gy arm. Inter...

It’s underreported and under-assessed and is different based on breast size, fractionation, and the volume of treatment. In practice, favor early intervention with physical therapy.

In our practice, it seems very patient-specific. This complication is dependent on the surgical approach, scar length, and orientation, the frequent development of post-op seromas, and the extent of the nodal resection. The surgery combined with the impact of the dose, fields, and techniques of RT.

Post-therapy edema is not uncommon. Fortunately, most women are not as troubled by swelling limited to the breast. I discuss edema or reduction in the size of the breast as being a realistic possibili...

I agree, edema is vastly underreported. Many patients, though only “mildly” affected, still struggle with comfort and “invest” considerable time and money in finding comfortable and functionable bras and support. We refer women to local custom lingerie shops, and many benefit from creative occupational lymphedema therapy. Though many don’t complain, it is often easy to see the signs of edema from the indentations left by their bra. I have a very low threshold for referral to our lymphedema thera...

I see clinically evident breast edema in more than 90% of patients 1 month after conclusion of breast RT. I advise intervention by the patient herself, in terms of nightly massage with a moderate degree of pressure (whatever the patient can tolerate). Most often it is resolved in 3-6 months. Makes mammography less painful. In some cases, it persists for longer periods. If arm edema becomes evident at any point, I refer them to a lymphedema clinic.