Low bone mass in women with lymphedema after breast cancer therapy

Background: The risk of breast cancer and osteoporosis increases with age. Comprehensive treatment of breast cancer (surgery, radiotherapy, chemotherapy, hormonal therapy) affects the possibility of secondary complications such as swelling of the lymph or osteoporosis.

The aim of this study was to establish a link between the occurrence of lymph edema and reduced bone mass in women treated for breast cancer.

Material and methods: We studied 39 women after breast cancer treatment. Circumference measurements of their upper limbs in 10 levels were taken. Proximal femur densitometry was carried out using Lunar DPX by the DXA method in femoral neck, trochanter major and Ward’s triangle sites.

Results: Based on the studies, we found lymph edema in 41% and reduced bone mass in 46% of women. There were no statistically significant differences in the circumference of the upper limbs using the distribution of T-score values in the femoral neck. There were no differences in the studies for osteoporosis in the femoral neck and trochanter major. In women with lymph edema, T-score at the Ward’s triangle demonstrated osteopenia (–1.02). In the group without edema, the T-score at the femoral neck and Ward’s triangle showed osteopenia (mean T-score –1.03 ±0.83, –1.66 ± 0.89, respectively). Statistically significant differences were observed between the results of densitometric studies carried out in the Ward’s triangle between women who have had or not lymph edema.

Conclusions: No osteoporosis was found in the group of women after mastectomy. Densitometry at Ward’s triangle seems to be helpful for bone mass loss assessment in breast cancer patients after mastectomy and with lymphedema.