Analysis of Factors Contributing to Severity of Breast Cancer Related Lymphedema
Identifieur interne : 002150 ( Main/Curation ); précédent : 002149; suivant : 002151Analysis of Factors Contributing to Severity of Breast Cancer Related Lymphedema
Auteurs : Michelle Coriddi ; Ibrahim Khansa ; Julie Stephens ; Michael Miller ; James Boehmler ; Pankaj TiwariSource :
- Annals of plastic surgery [ 0148-7043 ] ; 2015.
Descripteurs français
- KwdFr :
- Adulte, Adulte d'âge moyen, Aisselle, Analyse multivariée, Chimioradiothérapie adjuvante (effets indésirables), Complications postopératoires (étiologie), Facteurs de risque, Femelle, Humains, Indice de gravité médicale, Lymphadénectomie, Lymphoedème (étiologie), Mastectomie, Modèles linéaires, Sujet âgé, Tumeurs du sein (), Études rétrospectives.
- MESH :
- effets indésirables : Chimioradiothérapie adjuvante.
- étiologie : Complications postopératoires, Lymphoedème.
- Adulte, Adulte d'âge moyen, Aisselle, Analyse multivariée, Facteurs de risque, Femelle, Humains, Indice de gravité médicale, Lymphadénectomie, Mastectomie, Modèles linéaires, Sujet âgé, Tumeurs du sein, Études rétrospectives.
English descriptors
- KwdEn :
- Adult, Aged, Axilla, Breast Neoplasms (therapy), Chemoradiotherapy, Adjuvant (adverse effects), Female, Humans, Linear Models, Lymph Node Excision, Lymphedema (etiology), Mastectomy, Middle Aged, Multivariate Analysis, Postoperative Complications (etiology), Retrospective Studies, Risk Factors, Severity of Illness Index.
- MESH :
- adverse effects : Chemoradiotherapy, Adjuvant.
- etiology : Lymphedema, Postoperative Complications.
- therapy : Breast Neoplasms.
- Adult, Aged, Axilla, Female, Humans, Linear Models, Lymph Node Excision, Mastectomy, Middle Aged, Multivariate Analysis, Retrospective Studies, Risk Factors, Severity of Illness Index.
Abstract
Upper extremity lymphedema is a well-described complication of breast cancer treatment. Risk factors for lymphedema development include axillary lymph node dissection (ALND), obesity, increasing age, radiation and postoperative complications. In this study, we seek to evaluate a cohort of patients who have either self-referred or been referred to the department of physical therapy for lymphedema treatment. Our goal is to evaluate specific risk factors associated with the severity of lymphedema in this patient population.
All patients who presented to the Wexner Medical Center at the Ohio State University between January 1, 2009 and December 31, 2010 with a chief complaint of upper extremity lymphedema following breast cancer treatment were reviewed retrospectively. Upper extremity lymphedema index (UELI) was used as a severity indicator and patient factors including demographics and breast cancer treatments were evaluated. Univariate and multivariate statistical analyses were performed.
Fifty (4.5%) patients presented for upper extremity lymphedema treatment following breast cancer treatment (total of 1106 patients treated surgically for breast cancer). Greater UELI's were found in patients 50 years and older, those with ALND, radiation, chemotherapy, pathologic stage greater than 3, and an International Society of Lymphology (ISL) lymphedema stage 2 (p<0.05). The multivariate model showed age greater than 50 and pathologic stage greater than 3 were significant predictors of higher UELI (p<0.05).
In this study, we report that in patients who present for lymphedema treatment, increased UELI is significantly related to ALND, radiation therapy, chemotherapy, age and pathologic stage. An improved understanding of the patient population referred for lymphedema treatment, will allow for the identification of patients who may be candidates for therapeutic intervention.
Url:
DOI: 10.1097/SAP.0b013e31828d7285
PubMed: 23759971
PubMed Central: 4259855
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PMC:4259855Le document en format XML
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<author><name sortKey="Stephens, Julie" sort="Stephens, Julie" uniqKey="Stephens J" first="Julie" last="Stephens">Julie Stephens</name>
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<author><name sortKey="Miller, Michael" sort="Miller, Michael" uniqKey="Miller M" first="Michael" last="Miller">Michael Miller</name>
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<author><name sortKey="Khansa, Ibrahim" sort="Khansa, Ibrahim" uniqKey="Khansa I" first="Ibrahim" last="Khansa">Ibrahim Khansa</name>
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<profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Adult</term>
<term>Aged</term>
<term>Axilla</term>
<term>Breast Neoplasms (therapy)</term>
<term>Chemoradiotherapy, Adjuvant (adverse effects)</term>
<term>Female</term>
<term>Humans</term>
<term>Linear Models</term>
<term>Lymph Node Excision</term>
<term>Lymphedema (etiology)</term>
<term>Mastectomy</term>
<term>Middle Aged</term>
<term>Multivariate Analysis</term>
<term>Postoperative Complications (etiology)</term>
<term>Retrospective Studies</term>
<term>Risk Factors</term>
<term>Severity of Illness Index</term>
</keywords>
<keywords scheme="KwdFr" xml:lang="fr"><term>Adulte</term>
<term>Adulte d'âge moyen</term>
<term>Aisselle</term>
<term>Analyse multivariée</term>
<term>Chimioradiothérapie adjuvante (effets indésirables)</term>
<term>Complications postopératoires (étiologie)</term>
<term>Facteurs de risque</term>
<term>Femelle</term>
<term>Humains</term>
<term>Indice de gravité médicale</term>
<term>Lymphadénectomie</term>
<term>Lymphoedème (étiologie)</term>
<term>Mastectomie</term>
<term>Modèles linéaires</term>
<term>Sujet âgé</term>
<term>Tumeurs du sein ()</term>
<term>Études rétrospectives</term>
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<keywords scheme="MESH" qualifier="adverse effects" xml:lang="en"><term>Chemoradiotherapy, Adjuvant</term>
</keywords>
<keywords scheme="MESH" qualifier="effets indésirables" xml:lang="fr"><term>Chimioradiothérapie adjuvante</term>
</keywords>
<keywords scheme="MESH" qualifier="etiology" xml:lang="en"><term>Lymphedema</term>
<term>Postoperative Complications</term>
</keywords>
<keywords scheme="MESH" qualifier="therapy" xml:lang="en"><term>Breast Neoplasms</term>
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<keywords scheme="MESH" qualifier="étiologie" xml:lang="fr"><term>Complications postopératoires</term>
<term>Lymphoedème</term>
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<keywords scheme="MESH" xml:lang="en"><term>Adult</term>
<term>Aged</term>
<term>Axilla</term>
<term>Female</term>
<term>Humans</term>
<term>Linear Models</term>
<term>Lymph Node Excision</term>
<term>Mastectomy</term>
<term>Middle Aged</term>
<term>Multivariate Analysis</term>
<term>Retrospective Studies</term>
<term>Risk Factors</term>
<term>Severity of Illness Index</term>
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<term>Adulte d'âge moyen</term>
<term>Aisselle</term>
<term>Analyse multivariée</term>
<term>Facteurs de risque</term>
<term>Femelle</term>
<term>Humains</term>
<term>Indice de gravité médicale</term>
<term>Lymphadénectomie</term>
<term>Mastectomie</term>
<term>Modèles linéaires</term>
<term>Sujet âgé</term>
<term>Tumeurs du sein</term>
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<front><div type="abstract" xml:lang="en"><sec id="S1"><title>Background</title>
<p id="P1">Upper extremity lymphedema is a well-described complication of breast cancer treatment. Risk factors for lymphedema development include axillary lymph node dissection (ALND), obesity, increasing age, radiation and postoperative complications. In this study, we seek to evaluate a cohort of patients who have either self-referred or been referred to the department of physical therapy for lymphedema treatment. Our goal is to evaluate specific risk factors associated with the severity of lymphedema in this patient population.</p>
</sec>
<sec id="S2"><title>Methods</title>
<p id="P2">All patients who presented to the Wexner Medical Center at the Ohio State University between January 1, 2009 and December 31, 2010 with a chief complaint of upper extremity lymphedema following breast cancer treatment were reviewed retrospectively. Upper extremity lymphedema index (UELI) was used as a severity indicator and patient factors including demographics and breast cancer treatments were evaluated. Univariate and multivariate statistical analyses were performed.</p>
</sec>
<sec id="S3"><title>Results</title>
<p id="P3">Fifty (4.5%) patients presented for upper extremity lymphedema treatment following breast cancer treatment (total of 1106 patients treated surgically for breast cancer). Greater UELI's were found in patients 50 years and older, those with ALND, radiation, chemotherapy, pathologic stage greater than 3, and an International Society of Lymphology (ISL) lymphedema stage 2 (p<0.05). The multivariate model showed age greater than 50 and pathologic stage greater than 3 were significant predictors of higher UELI (p<0.05).</p>
</sec>
<sec id="S4"><title>Conclusion</title>
<p id="P4">In this study, we report that in patients who present for lymphedema treatment, increased UELI is significantly related to ALND, radiation therapy, chemotherapy, age and pathologic stage. An improved understanding of the patient population referred for lymphedema treatment, will allow for the identification of patients who may be candidates for therapeutic intervention.</p>
</sec>
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</front>
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