الفهرس 
INTRODUCTION AND RATIONALEOnly 14 pages are availabe for public view
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Abstract
Breast cancer-related arm lymphedema is one of the most devastating complications seen among breast cancer survivors, affecting the quality of their lives and exposing them to a higher risk of anxiety and depression. It also stands out as a daily reminder of their disease and the suffering they have gone through it. BCRL was previously thought to arise solely as a result of axillary lymph node removal. Yet, currently, the medical community believes that BCRL has a multifactorial nature, being associated with locoregional and systemic therapies and perhaps other patient-related factors that may influence a patient’s ability to form collateral lymphatic pathways after injury. Several risk factors have been postulated in the existing literature, such as adjuvant radiotherapy, taxane-based chemotherapy, lack of breast reconstruction after mastectomy, advanced disease stage, obesity, and physical inactivity. However, and to the best of our knowledge, very few studies have investigated these risk factors among Egyptian breast cancer survivors.
This case-control study included 111 breast cancer patients who were adult females (≥20 years), with pathologically confirmed breast cancer, and have received locoregional therapy, who presented to the clinical oncology outpatient clinics at SCU hospital, Ismailia, Egypt between May 2021 and January 2022. On the other hand, breast cancer patients with a recent diagnosis (<6 months) in whom BCRL may not have been evident yet, bilateral breast cancer, or presenting with an upper limb swelling due to other causes, were excluded. The enrolled women were assigned to one of two groups; the BCRL group which included 37 patients, and the non-BCRL group which included 74 patients. We aimed to assess the socio-demographic, clinicopathologic, and treatment-related risk factors associated with the development of BCRL. using limb volume as an objective method and CLUE score as a subjective method.
Among the thirty-seven women with BCRL, 13 patients (11.7%) had mild BCRL, 12 (10.8%) had moderate BCRL, and 12 (10.8%) developed severe BCRL, and their mean CLUE score was 31.4 points. The mean age of the studied women was 48.14 vs 49.28 years for the BCRL and the non-BCRL groups, respectively, and over half of them were premenopausal (56.8% of BCRL vs 52.7% of non-BCRL). Moreover, 56.8% of the BCRL group were married compared to 74.3% of the non-BCRL group. The vast majority were either illiterate or had a high school degree. Also, most of the studied women were unemployed (83.8% of BCRL vs 89.2% of non-BCRL) and over half of them lived in rural regions. Smoking was uncommon; yet, almost all