Zou L, Liu FH, Shen PP, Hu Y, Liu XQ, Xu YY, Pen QL, Wang B, Zhu YQ, Tian Y, et al.
Breast cancer (Tokyo, Japan). Date of publication 2018 May 1;volume 25(3):309-314.
1. Breast Cancer. 2018 May;25(3):309-314. doi: 10.1007/s12282-018-0830-3. Epub 2018
Feb 3.
The incidence and risk factors of related lymphedema for breast cancer survivors
post-operation: a 2-year follow-up prospective cohort study.
Zou L(1), Liu FH(1), Shen PP(1), Hu Y(1), Liu XQ(1), Xu YY(1), Pen QL(1), Wang
B(2), Zhu YQ(3), Tian Y(1).
Author information:
(1)Department of Radiotherapy and Oncology, The Second Affiliated Hospital of
Soochow University, No. 1055 San Xiang Road, Suzhou, 215004, Jiangsu, China.
(2)Department of Nursing, Second Hospital Affiliated of Soochow University,
Suzhou, 215004, China.
(3)Department of Radiotherapy and Oncology, The Second Affiliated Hospital of
Soochow University, No. 1055 San Xiang Road, Suzhou, 215004, Jiangsu, China.
yaqun_zhu@163.com.
PURPOSE: To investigate the incidence rate, severity and risk factors of related
lymphedema in breast cancer survivors.
METHODS: A 2-year follow-up prospective study of 387 women who had operation from
four hospitals from January 1, to December 31, 2014 was conducted. Limb volume
was measured by circumference and symptoms were measured using questionnaires
pre-treatment and 1, 3, 6, 12, 18, 24 months after surgery separately. The
incidence rates and the severity of lymphedema were evaluated, respectively. Risk
factors for the development of breast cancer-related lymphedema (BCRL) were
analyzed using log-rank test and Cox regression.
RESULTS: The incidences of BCRL were 4.4, 10.1, 15.2, 28.6, 31.2 and 32.5% at 1,
3, 6, 12, 18, 24 months after surgery, respectively, measured by Norman
questionnaire. The rates measured by arm circumference were 2.5, 6.7, 13.4, 21.4,
26.3 and 29.4%, respectively. About 114 (29.4% of 387) women were diagnosed with
BCRL, and 78 of them got mild lymphedema. Axillary lymph node dissection (ALND)
(HR = 5.2, 95% CI 1.6-17.3), radiotherapy (HR = 3.9, 95% CI 2.0-7.5), modified
radical mastectomy (MRM) (HR = 2.1, 95% CI 1.3-3.4), the number of positive lymph
nodes (HR = 1.1, 95% CI 1.0-1.2) and body mass index (BMI) (HR = 1.1, 95% CI
1.0-1.1) were independent risk factors for BCRL.
CONCLUSIONS: BCRL is a common complication for breast cancer patients after
surgery. It can be fairly diagnosed only 1 month post-operation and the
cumulative incidence of BCRL seems to be increasing over time, especially in the
first year after surgery. ALND, radiotherapy, MRM, the number of positive
axillary lymph nodes and BMI were found to be independent risk factors in the
development of BCRL in this study.
DOI: 10.1007/s12282-018-0830-3
PMID: 29397555
