Risk Factors Associated with Breast Lymphedema Following Breast Surgery
Identifieur interne : 003203 ( Main/Exploration ); précédent : 003202; suivant : 003204Risk Factors Associated with Breast Lymphedema Following Breast Surgery
Auteurs : Judy C. Boughey [États-Unis] ; Tanya L. Hoskin [États-Unis] ; Andrea L. Cheville [États-Unis] ; Joyce Miller [États-Unis] ; Margie D. Loprinzi [États-Unis] ; Kristine M. Thomsen [États-Unis] ; Shaun Maloney [États-Unis] ; Larry M. Baddour [États-Unis] ; Amy C. Degnim [États-Unis]Source :
- Annals of surgical oncology [ 1068-9265 ] ; 2013.
Descripteurs français
- KwdFr :
- Adulte, Adulte d'âge moyen, Aisselle, Biopsie de noeud lymphatique sentinelle (effets indésirables), Complications postopératoires (étiologie), Facteurs de risque, Femelle, Humains, Indice de masse corporelle, Lymphoedème (étiologie), Mastectomie (effets indésirables), Pronostic, Stade de la tumeur, Sujet âgé, Sujet âgé de 80 ans ou plus, Tumeurs du sein (), Études de suivi, Études prospectives.
- MESH :
- effets indésirables : Biopsie de noeud lymphatique sentinelle, Mastectomie.
- étiologie : Complications postopératoires, Lymphoedème.
- Adulte, Adulte d'âge moyen, Aisselle, Facteurs de risque, Femelle, Humains, Indice de masse corporelle, Pronostic, Stade de la tumeur, Sujet âgé, Sujet âgé de 80 ans ou plus, Tumeurs du sein, Études de suivi, Études prospectives.
English descriptors
- KwdEn :
- Adult, Aged, Aged, 80 and over, Axilla, Body Mass Index, Breast Neoplasms (complications), Breast Neoplasms (surgery), Female, Follow-Up Studies, Humans, Lymphedema (etiology), Mastectomy (adverse effects), Middle Aged, Neoplasm Staging, Postoperative Complications (etiology), Prognosis, Prospective Studies, Risk Factors, Sentinel Lymph Node Biopsy (adverse effects).
- MESH :
- adverse effects : Mastectomy, Sentinel Lymph Node Biopsy.
- complications : Breast Neoplasms.
- etiology : Lymphedema, Postoperative Complications.
- surgery : Breast Neoplasms.
- Adult, Aged, Aged, 80 and over, Axilla, Body Mass Index, Female, Follow-Up Studies, Humans, Middle Aged, Neoplasm Staging, Prognosis, Prospective Studies, Risk Factors.
Abstract
The development of breast lymphedema (BLE) following breast/axillary surgery is poorly characterized. We prospectively evaluated clinical and surgical factors associated with development of BLE.
Patients undergoing unilateral breast-conserving surgery were prospectively enrolled preoperatively and followed for development of BLE. To augment the number of patients with BLE for evaluation of risk factors, postoperative patients identified in the clinic with signs and symptoms of BLE were also enrolled. Logistic regression with Firth’s penalized likelihood bias-reduction method was used for univariate and multivariate analysis.
Of 144 women, 124 of them were enrolled preoperatively (38 of whom developed BLE) and 20 women with BLE were enrolled postoperatively. Any type of axillary surgery was the strongest factor associated with BLE (odds ratio 134, 95% CI: 18 to >1000). All 58 BLE events occurred in women with axillary surgery as compared to none of the 46 patients without axillary surgery (p<0.0001). Among 98 women who underwent axillary surgery, BLE did not occur more often after ALND versus SLN biopsy (p=0.38) and was not associated with total number of nodes removed (p=0.52). In multivariate analysis, factors associated with the development of BLE in the axillary surgery subgroup included baseline BMI (p=0.004), incision location (p=0.009), and prior surgical biopsy (p=0.01).
Risk of BLE is primarily related to performance of any axillary surgery but not extent of axillary surgery or number of lymph nodes removed. Other factors associated with BLE were increased BMI, incision location, and prior surgical excisional biopsy.
Url:
DOI: 10.1245/s10434-013-3408-5
PubMed: 24337542
PubMed Central: 4317332
Affiliations:
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Boughey</name><affiliation wicri:level="2"><nlm:aff id="A1">Department of Surgery, Mayo Clinic, Rochester, MN</nlm:aff><country xml:lang="fr">États-Unis</country><placeName><region type="state">Minnesota</region></placeName><wicri:cityArea>Department of Surgery, Mayo Clinic, Rochester</wicri:cityArea></affiliation></author><author><name sortKey="Hoskin, Tanya L" sort="Hoskin, Tanya L" uniqKey="Hoskin T" first="Tanya L." last="Hoskin">Tanya L. Hoskin</name><affiliation wicri:level="2"><nlm:aff id="A2">Division of Biomedical Statistics and Informatics, Mayo Clinic, Rochester, MN</nlm:aff><country xml:lang="fr">États-Unis</country><placeName><region type="state">Minnesota</region></placeName><wicri:cityArea>Division of Biomedical Statistics and Informatics, Mayo Clinic, Rochester</wicri:cityArea></affiliation></author><author><name sortKey="Cheville, Andrea L" sort="Cheville, Andrea L" uniqKey="Cheville A" first="Andrea L." last="Cheville">Andrea L. Cheville</name><affiliation wicri:level="2"><nlm:aff id="A3">Department of Physical Medicine and Rehabilitation, Mayo Clinic, Rochester, MN</nlm:aff><country xml:lang="fr">États-Unis</country><placeName><region type="state">Minnesota</region></placeName><wicri:cityArea>Department of Physical Medicine and Rehabilitation, Mayo Clinic, Rochester</wicri:cityArea></affiliation></author><author><name sortKey="Miller, Joyce" sort="Miller, Joyce" uniqKey="Miller J" first="Joyce" last="Miller">Joyce Miller</name><affiliation wicri:level="2"><nlm:aff id="A1">Department of Surgery, Mayo Clinic, Rochester, MN</nlm:aff><country xml:lang="fr">États-Unis</country><placeName><region type="state">Minnesota</region></placeName><wicri:cityArea>Department of Surgery, Mayo Clinic, Rochester</wicri:cityArea></affiliation></author><author><name sortKey="Loprinzi, Margie D" sort="Loprinzi, Margie D" uniqKey="Loprinzi M" first="Margie D." last="Loprinzi">Margie D. Loprinzi</name><affiliation wicri:level="2"><nlm:aff id="A1">Department of Surgery, Mayo Clinic, Rochester, MN</nlm:aff><country xml:lang="fr">États-Unis</country><placeName><region type="state">Minnesota</region></placeName><wicri:cityArea>Department of Surgery, Mayo Clinic, Rochester</wicri:cityArea></affiliation></author><author><name sortKey="Thomsen, Kristine M" sort="Thomsen, Kristine M" uniqKey="Thomsen K" first="Kristine M." last="Thomsen">Kristine M. Thomsen</name><affiliation wicri:level="2"><nlm:aff id="A2">Division of Biomedical Statistics and Informatics, Mayo Clinic, Rochester, MN</nlm:aff><country xml:lang="fr">États-Unis</country><placeName><region type="state">Minnesota</region></placeName><wicri:cityArea>Division of Biomedical Statistics and Informatics, Mayo Clinic, Rochester</wicri:cityArea></affiliation></author><author><name sortKey="Maloney, Shaun" sort="Maloney, Shaun" uniqKey="Maloney S" first="Shaun" last="Maloney">Shaun Maloney</name><affiliation wicri:level="2"><nlm:aff id="A2">Division of Biomedical Statistics and Informatics, Mayo Clinic, Rochester, MN</nlm:aff><country xml:lang="fr">États-Unis</country><placeName><region type="state">Minnesota</region></placeName><wicri:cityArea>Division of Biomedical Statistics and Informatics, Mayo Clinic, Rochester</wicri:cityArea></affiliation></author><author><name sortKey="Baddour, Larry M" sort="Baddour, Larry M" uniqKey="Baddour L" first="Larry M." last="Baddour">Larry M. Baddour</name><affiliation wicri:level="2"><nlm:aff id="A4">Division of Infectious Diseases, Mayo Clinic, Rochester, MN</nlm:aff><country xml:lang="fr">États-Unis</country><placeName><region type="state">Minnesota</region></placeName><wicri:cityArea>Division of Infectious Diseases, Mayo Clinic, Rochester</wicri:cityArea></affiliation></author><author><name sortKey="Degnim, Amy C" sort="Degnim, Amy C" uniqKey="Degnim A" first="Amy C." last="Degnim">Amy C. Degnim</name><affiliation wicri:level="2"><nlm:aff id="A1">Department of Surgery, Mayo Clinic, Rochester, MN</nlm:aff><country xml:lang="fr">États-Unis</country><placeName><region type="state">Minnesota</region></placeName><wicri:cityArea>Department of Surgery, Mayo Clinic, Rochester</wicri:cityArea></affiliation></author></analytic><series><title level="j">Annals of surgical oncology</title><idno type="ISSN">1068-9265</idno><idno type="eISSN">1534-4681</idno><imprint><date when="2013">2013</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Adult</term><term>Aged</term><term>Aged, 80 and over</term><term>Axilla</term><term>Body Mass Index</term><term>Breast Neoplasms (complications)</term><term>Breast Neoplasms (surgery)</term><term>Female</term><term>Follow-Up Studies</term><term>Humans</term><term>Lymphedema (etiology)</term><term>Mastectomy (adverse effects)</term><term>Middle Aged</term><term>Neoplasm Staging</term><term>Postoperative Complications (etiology)</term><term>Prognosis</term><term>Prospective Studies</term><term>Risk Factors</term><term>Sentinel Lymph Node Biopsy (adverse effects)</term></keywords><keywords scheme="KwdFr" xml:lang="fr"><term>Adulte</term><term>Adulte d'âge moyen</term><term>Aisselle</term><term>Biopsie de noeud lymphatique sentinelle (effets indésirables)</term><term>Complications postopératoires (étiologie)</term><term>Facteurs de risque</term><term>Femelle</term><term>Humains</term><term>Indice de masse corporelle</term><term>Lymphoedème (étiologie)</term><term>Mastectomie (effets indésirables)</term><term>Pronostic</term><term>Stade de la tumeur</term><term>Sujet âgé</term><term>Sujet âgé de 80 ans ou plus</term><term>Tumeurs du sein ()</term><term>Études de suivi</term><term>Études prospectives</term></keywords><keywords scheme="MESH" qualifier="adverse effects" xml:lang="en"><term>Mastectomy</term><term>Sentinel Lymph Node Biopsy</term></keywords><keywords scheme="MESH" qualifier="complications" xml:lang="en"><term>Breast Neoplasms</term></keywords><keywords scheme="MESH" qualifier="effets indésirables" xml:lang="fr"><term>Biopsie de noeud lymphatique sentinelle</term><term>Mastectomie</term></keywords><keywords scheme="MESH" qualifier="etiology" xml:lang="en"><term>Lymphedema</term><term>Postoperative Complications</term></keywords><keywords scheme="MESH" qualifier="surgery" xml:lang="en"><term>Breast Neoplasms</term></keywords><keywords scheme="MESH" qualifier="étiologie" xml:lang="fr"><term>Complications postopératoires</term><term>Lymphoedème</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Adult</term><term>Aged</term><term>Aged, 80 and over</term><term>Axilla</term><term>Body Mass Index</term><term>Female</term><term>Follow-Up Studies</term><term>Humans</term><term>Middle Aged</term><term>Neoplasm Staging</term><term>Prognosis</term><term>Prospective Studies</term><term>Risk Factors</term></keywords><keywords scheme="MESH" xml:lang="fr"><term>Adulte</term><term>Adulte d'âge moyen</term><term>Aisselle</term><term>Facteurs de risque</term><term>Femelle</term><term>Humains</term><term>Indice de masse corporelle</term><term>Pronostic</term><term>Stade de la tumeur</term><term>Sujet âgé</term><term>Sujet âgé de 80 ans ou plus</term><term>Tumeurs du sein</term><term>Études de suivi</term><term>Études prospectives</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><sec id="S1"><title>Introduction</title><p id="P1">The development of breast lymphedema (BLE) following breast/axillary surgery is poorly characterized. We prospectively evaluated clinical and surgical factors associated with development of BLE.</p></sec><sec id="S2"><title>Methods</title><p id="P2">Patients undergoing unilateral breast-conserving surgery were prospectively enrolled preoperatively and followed for development of BLE. To augment the number of patients with BLE for evaluation of risk factors, postoperative patients identified in the clinic with signs and symptoms of BLE were also enrolled. Logistic regression with Firth’s penalized likelihood bias-reduction method was used for univariate and multivariate analysis.</p></sec><sec id="S3"><title>Results</title><p id="P3">Of 144 women, 124 of them were enrolled preoperatively (38 of whom developed BLE) and 20 women with BLE were enrolled postoperatively. Any type of axillary surgery was the strongest factor associated with BLE (odds ratio 134, 95% CI: 18 to >1000). All 58 BLE events occurred in women with axillary surgery as compared to none of the 46 patients without axillary surgery (p<0.0001). Among 98 women who underwent axillary surgery, BLE did not occur more often after ALND versus SLN biopsy (p=0.38) and was not associated with total number of nodes removed (p=0.52). In multivariate analysis, factors associated with the development of BLE in the axillary surgery subgroup included baseline BMI (p=0.004), incision location (p=0.009), and prior surgical biopsy (p=0.01).</p></sec><sec id="S4"><title>Conclusions</title><p id="P4">Risk of BLE is primarily related to performance of any axillary surgery but not extent of axillary surgery or number of lymph nodes removed. Other factors associated with BLE were increased BMI, incision location, and prior surgical excisional biopsy.</p></sec></div></front></TEI><affiliations><list><country><li>États-Unis</li></country><region><li>Minnesota</li></region></list><tree><country name="États-Unis"><region name="Minnesota"><name sortKey="Boughey, Judy C" sort="Boughey, Judy C" uniqKey="Boughey J" first="Judy C." last="Boughey">Judy C. Boughey</name></region><name sortKey="Baddour, Larry M" sort="Baddour, Larry M" uniqKey="Baddour L" first="Larry M." last="Baddour">Larry M. Baddour</name><name sortKey="Cheville, Andrea L" sort="Cheville, Andrea L" uniqKey="Cheville A" first="Andrea L." last="Cheville">Andrea L. Cheville</name><name sortKey="Degnim, Amy C" sort="Degnim, Amy C" uniqKey="Degnim A" first="Amy C." last="Degnim">Amy C. Degnim</name><name sortKey="Hoskin, Tanya L" sort="Hoskin, Tanya L" uniqKey="Hoskin T" first="Tanya L." last="Hoskin">Tanya L. Hoskin</name><name sortKey="Loprinzi, Margie D" sort="Loprinzi, Margie D" uniqKey="Loprinzi M" first="Margie D." last="Loprinzi">Margie D. Loprinzi</name><name sortKey="Maloney, Shaun" sort="Maloney, Shaun" uniqKey="Maloney S" first="Shaun" last="Maloney">Shaun Maloney</name><name sortKey="Miller, Joyce" sort="Miller, Joyce" uniqKey="Miller J" first="Joyce" last="Miller">Joyce Miller</name><name sortKey="Thomsen, Kristine M" sort="Thomsen, Kristine M" uniqKey="Thomsen K" first="Kristine M." last="Thomsen">Kristine M. Thomsen</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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