Risk Factors for Arm Lymphedema in a Cohort of Breast Cancer Patients Followed up for 10 Years
Identifieur interne : 001880 ( Main/Exploration ); précédent : 001879; suivant : 001881Risk Factors for Arm Lymphedema in a Cohort of Breast Cancer Patients Followed up for 10 Years
Auteurs : René Aloisio Da Costa Vieira [Brésil] ; Allini Mafra Da Costa [Brésil] ; Josue Lopes De Souza [Brésil] ; Rafael Richieri Coelho [Brésil] ; Cleyton Zanardo De Oliveira [Brésil] ; Almir José Sarri [Brésil] ; Renato José Affonso Junior [Brésil] ; Gustavo Zucca-Matthes [Brésil]Source :
- Breast Care [ 1661-3791 ] ; 2015.
Abstract
The etiology of lymphedema is multifactorial, and definition criteria of lymphedema, its limitation, and follow-up must be considered in studies related to risk factors. The aim of this study is to evaluate risk factors related to arm lymphedema in a cohort study with a long follow-up.
The study was performed in 622 breast cancer patients. The main endpoint reported was the presence of clinical lymphedema reported in medical records. Univariate and multivariate regression analyses were performed to identify factors related to lymphedema.
66.4% of the patients were submitted to mastectomy, 88.4% to level III axillary lymphadenectomy, 34.9% to radiotherapy in the supraclavicular fossa, and 4.3% to axillary radiotherapy. The mean follow-up was 96.7 months. 45 patients (7.2%) developed lymphedema, of which 82.2% had developed lymphedema at 60 months. Univariate regression analysis showed that supraclavicular radiotherapy, adjuvant/palliative chemotherapy, ≥ 15 lymph nodes dissected, and axillary surgery increase the lymphedema rate by 1.87, 2.28, 2.03, and 6.17, respectively. Adjusted multivariate regression analysis showed that the combination of axillary dissection and number of lymph nodes dissected was the main factor related to lymphedema (p = 0.017).
In the pre-sentinel era, axillary dissection and the number of lymph nodes resected are related to 10-year lymphedema.
Url:
DOI: 10.1159/000442489
PubMed: 27051396
PubMed Central: 4813649
Affiliations:
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Breast Reconstruction Department, Barretos Cancer Hospital, Pio XII Foundation, Barretos</wicri:regionArea><wicri:noRegion>Barretos</wicri:noRegion></affiliation></author><author><name sortKey="Da Costa, Allini Mafra" sort="Da Costa, Allini Mafra" uniqKey="Da Costa A" first="Allini Mafra" last="Da Costa">Allini Mafra Da Costa</name><affiliation wicri:level="1"><nlm:aff id="aff2">Hospital-based Cancer Registry, Barretos Cancer Hospital, Pio XII Foundation, Barretos, Brazil</nlm:aff><country xml:lang="fr">Brésil</country><wicri:regionArea>Hospital-based Cancer Registry, Barretos Cancer Hospital, Pio XII Foundation, Barretos</wicri:regionArea><wicri:noRegion>Barretos</wicri:noRegion></affiliation></author><author><name sortKey="De Souza, Josue Lopes" sort="De Souza, Josue Lopes" uniqKey="De Souza J" first="Josue Lopes" last="De Souza">Josue Lopes De Souza</name><affiliation wicri:level="1"><nlm:aff id="aff1">Mastology and Breast Reconstruction Department, Barretos Cancer Hospital, Pio XII Foundation, Barretos, Brazil</nlm:aff><country xml:lang="fr">Brésil</country><wicri:regionArea>Mastology and Breast Reconstruction Department, Barretos Cancer Hospital, Pio XII Foundation, Barretos</wicri:regionArea><wicri:noRegion>Barretos</wicri:noRegion></affiliation></author><author><name sortKey="Coelho, Rafael Richieri" sort="Coelho, Rafael Richieri" uniqKey="Coelho R" first="Rafael Richieri" last="Coelho">Rafael Richieri Coelho</name><affiliation wicri:level="1"><nlm:aff id="aff3">Department of Physiotherapy, Barretos Cancer Hospital, Pio XII Foundation, Barretos, Brazil</nlm:aff><country xml:lang="fr">Brésil</country><wicri:regionArea>Department of Physiotherapy, Barretos Cancer Hospital, Pio XII Foundation, Barretos</wicri:regionArea><wicri:noRegion>Barretos</wicri:noRegion></affiliation></author><author><name sortKey="De Oliveira, Cleyton Zanardo" sort="De Oliveira, Cleyton Zanardo" uniqKey="De Oliveira C" first="Cleyton Zanardo" last="De Oliveira">Cleyton Zanardo De Oliveira</name><affiliation wicri:level="1"><nlm:aff id="aff4">Epidemiology and Biostatistics Nucleus, Barretos Cancer Hospital, Pio XII Foundation, Barretos, Brazil</nlm:aff><country xml:lang="fr">Brésil</country><wicri:regionArea>Epidemiology and Biostatistics Nucleus, Barretos Cancer Hospital, Pio XII Foundation, Barretos</wicri:regionArea><wicri:noRegion>Barretos</wicri:noRegion></affiliation></author><author><name sortKey="Sarri, Almir Jose" sort="Sarri, Almir Jose" uniqKey="Sarri A" first="Almir José" last="Sarri">Almir José Sarri</name><affiliation wicri:level="1"><nlm:aff id="aff3">Department of Physiotherapy, Barretos Cancer Hospital, Pio XII Foundation, Barretos, Brazil</nlm:aff><country xml:lang="fr">Brésil</country><wicri:regionArea>Department of Physiotherapy, Barretos Cancer Hospital, Pio XII Foundation, Barretos</wicri:regionArea><wicri:noRegion>Barretos</wicri:noRegion></affiliation></author><author><name sortKey="Junior, Renato Jose Affonso" sort="Junior, Renato Jose Affonso" uniqKey="Junior R" first="Renato José Affonso" last="Junior">Renato José Affonso Junior</name><affiliation wicri:level="1"><nlm:aff id="aff5">Department of Radiotherapy, Barretos Cancer Hospital, Pio XII Foundation, Barretos, Brazil</nlm:aff><country xml:lang="fr">Brésil</country><wicri:regionArea>Department of Radiotherapy, Barretos Cancer Hospital, Pio XII Foundation, Barretos</wicri:regionArea><wicri:noRegion>Barretos</wicri:noRegion></affiliation></author><author><name sortKey="Zucca Matthes, Gustavo" sort="Zucca Matthes, Gustavo" uniqKey="Zucca Matthes G" first="Gustavo" last="Zucca-Matthes">Gustavo Zucca-Matthes</name><affiliation wicri:level="1"><nlm:aff id="aff1">Mastology and Breast Reconstruction Department, Barretos Cancer Hospital, Pio XII Foundation, Barretos, Brazil</nlm:aff><country xml:lang="fr">Brésil</country><wicri:regionArea>Mastology and Breast Reconstruction Department, Barretos Cancer Hospital, Pio XII Foundation, Barretos</wicri:regionArea><wicri:noRegion>Barretos</wicri:noRegion></affiliation></author></analytic><series><title level="j">Breast Care</title><idno type="ISSN">1661-3791</idno><idno type="eISSN">1661-3805</idno><imprint><date when="2015">2015</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><title>Summary</title><sec><title>Background</title><p>The etiology of lymphedema is multifactorial, and definition criteria of lymphedema, its limitation, and follow-up must be considered in studies related to risk factors. The aim of this study is to evaluate risk factors related to arm lymphedema in a cohort study with a long follow-up.</p></sec><sec><title>Patients and Methods</title><p>The study was performed in 622 breast cancer patients. The main endpoint reported was the presence of clinical lymphedema reported in medical records. Univariate and multivariate regression analyses were performed to identify factors related to lymphedema.</p></sec><sec><title>Results</title><p>66.4% of the patients were submitted to mastectomy, 88.4% to level III axillary lymphadenectomy, 34.9% to radiotherapy in the supraclavicular fossa, and 4.3% to axillary radiotherapy. The mean follow-up was 96.7 months. 45 patients (7.2%) developed lymphedema, of which 82.2% had developed lymphedema at 60 months. Univariate regression analysis showed that supraclavicular radiotherapy, adjuvant/palliative chemotherapy, ≥ 15 lymph nodes dissected, and axillary surgery increase the lymphedema rate by 1.87, 2.28, 2.03, and 6.17, respectively. Adjusted multivariate regression analysis showed that the combination of axillary dissection and number of lymph nodes dissected was the main factor related to lymphedema (p = 0.017).</p></sec><sec><title>Conclusion</title><p>In the pre-sentinel era, axillary dissection and the number of lymph nodes resected are related to 10-year lymphedema.</p></sec></div></front></TEI><affiliations><list><country><li>Brésil</li></country></list><tree><country name="Brésil"><noRegion><name sortKey="Vieira, Rene Aloisio Da Costa" sort="Vieira, Rene Aloisio Da Costa" uniqKey="Vieira R" first="René Aloisio Da Costa" last="Vieira">René Aloisio Da Costa Vieira</name></noRegion><name sortKey="Coelho, Rafael Richieri" sort="Coelho, Rafael Richieri" uniqKey="Coelho R" first="Rafael Richieri" last="Coelho">Rafael Richieri Coelho</name><name sortKey="Da Costa, Allini Mafra" sort="Da Costa, Allini Mafra" uniqKey="Da Costa A" first="Allini Mafra" last="Da Costa">Allini Mafra Da Costa</name><name sortKey="De Oliveira, Cleyton Zanardo" sort="De Oliveira, Cleyton Zanardo" uniqKey="De Oliveira C" first="Cleyton Zanardo" last="De Oliveira">Cleyton Zanardo De Oliveira</name><name sortKey="De Souza, Josue Lopes" sort="De Souza, Josue Lopes" uniqKey="De Souza J" first="Josue Lopes" last="De Souza">Josue Lopes De Souza</name><name sortKey="Junior, Renato Jose Affonso" sort="Junior, Renato Jose Affonso" uniqKey="Junior R" first="Renato José Affonso" last="Junior">Renato José Affonso Junior</name><name sortKey="Sarri, Almir Jose" sort="Sarri, Almir Jose" uniqKey="Sarri A" first="Almir José" last="Sarri">Almir José Sarri</name><name sortKey="Zucca Matthes, Gustavo" sort="Zucca Matthes, Gustavo" uniqKey="Zucca Matthes G" first="Gustavo" last="Zucca-Matthes">Gustavo Zucca-Matthes</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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