{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,9]],"date-time":"2026-01-09T12:18:20Z","timestamp":1767961100596,"version":"3.49.0"},"reference-count":30,"publisher":"Oxford University Press (OUP)","issue":"7","license":[{"start":{"date-parts":[[1986,7,1]],"date-time":"1986-07-01T00:00:00Z","timestamp":520560000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[1986,7,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:p>The incidence of lymphoedema was studied in 200 patients following a variety of treatments for operable breast cancer. 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 differences in size of the operated and normal arm. Arm circumference measurements were inaccurate. Subjective lymphoedema was present in 14 per cent whereas objective lymphoedema (a difference in limb volume &amp;gt; 200 ml) was present in 25.5 per cent. Independent risk factors contributing towards the development of subjective late lymphoedema were the extent of axillary surgery (P &amp;lt; 0.05), axillary radiotherapy (P &amp;lt; 0.001) and pathological nodal status (P &amp;lt; 0.10). The risk of developing late lymphoedema was unrelated to age, menopausal status, handedness, early lymphoedema, surgical and radiotherapeutic complications, total dose of radiation, time interval since presentation, drug therapy, surgery to the breast, radiotherapy to the breast and tumour T stage. The incidence of subjective late lymphoedema was similar after axillary radiotherapy alone (8.3 per cent), axillary sampling plus radiotherapy (9.1 percent) and axillary clearance alone (7.4 per cent). The incidence after axillary clearance plus radiotherapy was significantly greater (38.3 per cent, P &amp;lt; 0.001). Axillary radiotherapy should be avoided in patients who have had a total axillary clearance.<\/jats:p>","DOI":"10.1002\/bjs.1800730723","type":"journal-article","created":{"date-parts":[[2007,3,3]],"date-time":"2007-03-03T07:29:45Z","timestamp":1172906985000},"page":"580-584","source":"Crossref","is-referenced-by-count":550,"title":["Risk of lymphoedema following the treatment of breast cancer"],"prefix":"10.1093","volume":"73","author":[{"given":"M W","family":"Kissin","sequence":"first","affiliation":[{"name":"Academic Surgical Unit, Royal Marsden Hospital , Fulham Road, London SW3,","place":["UK"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"G Querci","family":"Della Rovere","sequence":"additional","affiliation":[{"name":"Academic Surgical Unit, Royal Marsden Hospital , Fulham Road, London SW3,","place":["UK"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"D","family":"Easton","sequence":"additional","affiliation":[{"name":"Section of Epidemiology, Institute of Cancer Research , Sutton, Surrey,","place":["UK"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"G","family":"Westbury","sequence":"additional","affiliation":[{"name":"Academic Surgical Unit, Royal Marsden Hospital , Fulham Road, London SW3,","place":["UK"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[1986,7,1]]},"reference":[{"key":"2024092718194018300_bib1","first-page":"129","article-title":"The prevention and management of lymphoedema after treatment for breast cancer","volume":"3","author":"Jungi","year":"1981","journal-title":"Int Rehab Med"},{"key":"2024092718194018300_bib2","doi-asserted-by":"crossref","first-page":"783","DOI":"10.1016\/S0140-6736(00)67447-0","article-title":"Lymphangioplasty: New method for relief of brawny arm of breast-cancer and for similar conditions of lymphatic origin","volume":"i","author":"Handley","year":"1908","journal-title":"Lancet"},{"key":"2024092718194018300_bib3","first-page":"550","article-title":"Postmastectomy swelling of the arm with note on effect of segmental resection of axillary vein at time of radical mastectomy","volume":"57","author":"Lobb","year":"1949","journal-title":"West J Surg"},{"key":"2024092718194018300_bib4","doi-asserted-by":"crossref","first-page":"95","DOI":"10.1001\/jama.1962.03050150001001","article-title":"Causes and treatment of postmastectomy lymphedema of the arm. Report of 114 cases","volume":"180","author":"Britton","year":"1962","journal-title":"J Am Med Assoc"},{"key":"2024092718194018300_bib5","doi-asserted-by":"crossref","first-page":"4","DOI":"10.1002\/bjs.1800530150","article-title":"Swelling of the arm following mastectomy","volume":"53","author":"Hughes","year":"1966","journal-title":"Br J Surg"},{"key":"2024092718194018300_bib6","first-page":"232","volume-title":"The Breast","author":"Leis","year":"1978","edition":"1st"},{"key":"2024092718194018300_bib7","first-page":"270","article-title":"A new approach to the conservative treatment of early breast cancer","volume":"95","author":"Hayward","year":"1984","journal-title":"Surgery"},{"key":"2024092718194018300_bib8","doi-asserted-by":"crossref","first-page":"6","DOI":"10.1056\/NEJM198107023050102","article-title":"Comparing radical mastectomy with quadrantectomy, axillary dissection and radiotherapy in patients with small cancers of the breast","volume":"305","author":"Veronesi","year":"1981","journal-title":"N Engl J Med"},{"key":"2024092718194018300_bib9","doi-asserted-by":"crossref","first-page":"349","DOI":"10.1002\/1097-0142(19840115)53:2<349::AID-CNCR2820530230>3.0.CO;2-B","article-title":"Breast conservation in the treatment of early breast cancer. A 20 year follow up","volume":"53","author":"Osborne","year":"1984","journal-title":"Cancer"},{"key":"2024092718194018300_bib10","first-page":"309","article-title":"Swelling of the arm after operations for cancer of the breast \u2013 Elephatiasis Chirurgica \u2013 Its cause and prevention","volume":"32","author":"Halsted","year":"1921","journal-title":"Bull Johns Hopkins Hosp"},{"key":"2024092718194018300_bib11","first-page":"718","volume-title":"Disease of Breast","author":"Haagensen","year":"1971","edition":"2nd"},{"key":"2024092718194018300_bib12","first-page":"91","article-title":"Lymphoedema: Pathophysiology and classification","volume":"26","author":"Browse","year":"1985","journal-title":"J Cardiovasc Surg"},{"key":"2024092718194018300_bib13","first-page":"73","article-title":"The role of infection in post-mastectomy lymphedema","volume":"14","author":"Mozes","year":"1982","journal-title":"Surg Ann"},{"key":"2024092718194018300_bib14","first-page":"127","article-title":"Secondary limb edemas following irradiation","volume":"14","author":"Tsyb","year":"1981","journal-title":"Lymphology"},{"key":"2024092718194018300_bib15","first-page":"191","article-title":"The role of the lateral upper arm bundle and the lymphatic watersheds in the formation of collateral pathways in lymphedema","volume":"31","author":"Kubik","year":"1980","journal-title":"Acta Biol Acad Sci Hung"},{"key":"2024092718194018300_bib16","first-page":"752","article-title":"Pathologic basis for swelling of the arm following radical amputation of breast","volume":"67","author":"Veal","year":"1938","journal-title":"Surg Gynecol Obstet"},{"key":"2024092718194018300_bib17","doi-asserted-by":"crossref","first-page":"618","DOI":"10.1002\/1097-0142(194811)1:4<618::AID-CNCR2820010408>3.0.CO;2-P","article-title":"Resection of the axillary vein in radical mastectomy. Its relation to mechanism of lymphedema","volume":"1","author":"MacDonald","year":"1948","journal-title":"Cancer"},{"key":"2024092718194018300_bib18","doi-asserted-by":"crossref","first-page":"282","DOI":"10.1097\/00000658-196112000-00037","article-title":"Prevention of arm lymphedema following radical mastectomy","volume":"154","author":"Mustard","year":"1961","journal-title":"Ann Surg"},{"key":"2024092718194018300_bib19","doi-asserted-by":"crossref","first-page":"693","DOI":"10.1002\/bjs.1800691202","article-title":"Manchester regional breast study \u2013 5 and 10 year results","volume":"69","author":"Lythgoe","year":"1982","journal-title":"Br J Surg"},{"key":"2024092718194018300_bib20","doi-asserted-by":"crossref","first-page":"880","DOI":"10.1097\/00000658-196912000-00003","article-title":"Conservative radical mastectomy (Patey's operation)","volume":"170","author":"Handley","year":"1969","journal-title":"Ann Surg"},{"key":"2024092718194018300_bib21","doi-asserted-by":"crossref","first-page":"71","DOI":"10.1097\/00000658-196407000-00010","article-title":"The rational treatment for carcinoma of the breast?","volume":"160","author":"Devitt","year":"1964","journal-title":"Ann Surg"},{"key":"2024092718194018300_bib22","doi-asserted-by":"crossref","first-page":"624","DOI":"10.1097\/00000658-197205000-00002","article-title":"Modified radical mastectomy","volume":"175","author":"Madden","year":"1972","journal-title":"Ann Surg"},{"key":"2024092718194018300_bib23","doi-asserted-by":"crossref","first-page":"371","DOI":"10.1097\/00000658-198209000-00017","article-title":"Simple mastectomy and axillary node sampling (Pectoral node biopsy) in the management of primary breast cancer","volume":"196","author":"Forrest","year":"1982","journal-title":"Ann Surg"},{"key":"2024092718194018300_bib24","doi-asserted-by":"crossref","first-page":"674","DOI":"10.1056\/NEJM198503143121102","article-title":"Ten year results of a randomised clinical trial comparing radical mastectomy and total mastectomy with or without radiation","volume":"312","author":"Fisher","year":"1985","journal-title":"N Engl J Med"},{"key":"2024092718194018300_bib25","doi-asserted-by":"crossref","first-page":"1253","DOI":"10.1002\/1097-0142(19840315)53:6<1253::AID-CNCR2820530606>3.0.CO;2-I","article-title":"Breast conserving treatment for breast cancer in Stockholm, Sweden, 1977\u20131981","volume":"53","author":"Cedermark","year":"1984","journal-title":"Cancer"},{"key":"2024092718194018300_bib26","doi-asserted-by":"crossref","first-page":"521","DOI":"10.1001\/archsurg.1983.01390050005001","article-title":"Conservation surgery and irradiation as treatment for early breast cancer","volume":"118","author":"Romsdahl","year":"1983","journal-title":"Arch Surg"},{"key":"2024092718194018300_bib27","first-page":"465","article-title":"Post-mastectomy lymphedema","volume":"101","author":"Wilhelm","year":"1974","journal-title":"Va Med Mon"},{"key":"2024092718194018300_bib28","first-page":"449","article-title":"Lymphedema incidence after specific postmastectomy therapy","volume":"62","author":"Markowski","year":"1981","journal-title":"Arch Phys Med Rehabil"},{"key":"2024092718194018300_bib29","doi-asserted-by":"crossref","first-page":"449","DOI":"10.1016\/0047-0740(80)90052-2","article-title":"Di-chromatic differential absorptiometry for assessment of lymphedema","volume":"7","author":"Bolin","year":"1980","journal-title":"Int J Nucl Med Biol"},{"key":"2024092718194018300_bib30","first-page":"241","article-title":"CAT scanning in the management of the lymphedematous limb","volume":"2","author":"Stewart","year":"1998","journal-title":"Immun Haem Res"}],"container-title":["Journal of British Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1002%2Fbjs.1800730723","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/academic.oup.com\/bjs\/article-pdf\/73\/7\/580\/59381884\/bjs1800730723.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/bjs\/article-pdf\/73\/7\/580\/59381884\/bjs1800730723.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,9,27]],"date-time":"2024-09-27T18:19:51Z","timestamp":1727461191000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/bjs\/article\/73\/7\/580\/6181891"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[1986,7,1]]},"references-count":30,"journal-issue":{"issue":"7","published-online":{"date-parts":[[1986,7,1]]},"published-print":{"date-parts":[[1986,7,1]]}},"URL":"https:\/\/doi.org\/10.1002\/bjs.1800730723","relation":{},"ISSN":["0007-1323","1365-2168"],"issn-type":[{"value":"0007-1323","type":"print"},{"value":"1365-2168","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[1986,7]]},"published":{"date-parts":[[1986,7,1]]}}}