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The objectives of this study were to determine whether patients reporting symptoms are more likely to develop lymphedema and to describe the temporal relationship between symptom onset and lymphedema. This was a prospective longitudinal cohort study of 647 women treated for breast cancer and screened for lymphedema using arm volume measurements and subjective questionnaires (n=647; 2284 questionnaires [median 3.5 per patient, range=1-24]). Primary study outcome was lymphedema (relative volume change ≥10%). The Kaplan-Meier method was used to es