A SEER-Medicare population-based study of lymphedema-related claims incidence following breast cancer in men

Each year there are an estimated 200,000 new breast cancer cases diagnosed in the United States; of these, 1% of cases are in men. Lymphedema can be a devastating complication from breast cancer and its treatment. Currently, almost all lymphedema-related research is based on women and extrapolated to men. We conducted the first population-based study of men with incident breast cancer of any stage, diagnosed from 1998 to 2005, who were 65 years and older in the Surveillance, Epidemiology, and End Results (SEER)-Medicare linked database. We utilized claims related to lymphedema and lymphedema treatment in our cohort. We defined ‘lymphedema-specific’ claims to contain the word ‘lymphedema’ in the Medicare claim description; similarly, ‘lymphedema-related’ claims were defined as treatments reimbursed for lymphedema but not necessarily containing the word ‘lymphedema’ in the Medicare claim description. We identified 628 men with incident breast cancer from 1998 to 2005 who were 65 years and older. The cumulative incidence, censored for deaths, of lymphedema-specific claims at 2, 3, 4, and 5 years was 8.0, 9.2, 10.5, and 10.5%, respectively. The median follow-up was 3.4 years and for those without any event was 4.7 years. The cumulative incidence, censored for deaths, of lymphedema-related claims at 2, 3, 4, and 5 years was 26.9, 32.2, 35.4, and 39.8%. Rates for men were similar to analogous rates for women. Lymphedema is a common complication affecting men with breast cancer as well as women and appropriate treatment and rehabilitation strategies need to be implemented for both genders.