Impact of body mass index and weight fluctuation on lymphedema risk in patients treated for breast cancer
Identifieur interne : 003C75 ( Main/Exploration ); précédent : 003C74; suivant : 003C76Impact of body mass index and weight fluctuation on lymphedema risk in patients treated for breast cancer
Auteurs : Lauren S. Jammallo [États-Unis] ; Cynthia L. Miller [États-Unis] ; Marybeth Singer [États-Unis] ; Nora K. Horick [États-Unis] ; Melissa N. Skolny [États-Unis] ; Michelle C. Specht [États-Unis] ; Jean O'Toole [États-Unis] ; Alphonse G. Taghian [États-Unis]Source :
- Breast cancer research and treatment [ 0167-6806 ] ; 2013.
Descripteurs français
- KwdFr :
- MESH :
- épidémiologie : Lymphoedème.
- étiologie : Lymphoedème.
- Pascal (Inist)
- Adulte, Adulte d'âge moyen, Femelle, Humains, Indice de masse corporelle, Indice masse corporelle, Poids, Fluctuation, Lymphoedème, Facteur risque, Homme, Poids du corps, Période postopératoire, Période préopératoire, Risque, Sujet âgé, Sujet âgé de 80 ans ou plus, Traitement, Cancer du sein, Tumeurs du sein, Études de suivi.
- Wicri :
- topic : Homme.
English descriptors
- KwdEn :
- Adult, Aged, Aged, 80 and over, Body Mass Index, Body Weight, Body mass index, Breast Neoplasms (complications), Breast Neoplasms (surgery), Breast cancer, Female, Fluctuations, Follow-Up Studies, Human, Humans, Lymphedema, Lymphedema (epidemiology), Lymphedema (etiology), Middle Aged, Postoperative Period, Preoperative Period, Risk, Risk factor, Treatment, Weight.
- MESH :
- complications : Breast Neoplasms.
- epidemiology : Lymphedema.
- etiology : Lymphedema.
- surgery : Breast Neoplasms.
- Adult, Aged, Aged, 80 and over, Body Mass Index, Body Weight, Female, Follow-Up Studies, Humans, Middle Aged, Postoperative Period, Preoperative Period, Risk.
Abstract
Identifying risk factors for lymphedema in patients treated for breast cancer has become increasingly important, given the current lack of standardization surrounding diagnosis and treatment. Reports on the association of body mass index (BMI) and weight change with lymphedema risk are conflicting. We sought to examine the impact of pre-operative BMI and post-treatment weight change on the incidence of lymphedema. From 2005 to 2011, 787 newly diagnosed breast cancer patients underwent prospective arm volume measurements with a Perometer pre- and post-operatively. BMI was calculated from same-day weight and height measurements. Lymphedema was defined as a relative volume change (RVC) of ≥ 10 %. Univariate and multivariate Cox proportional hazards models were used to evaluate the association between lymphedema risk and pre-operative BMI, weight change, and other demographic and treatment factors. By multivariate analysis, a pre-operative BMI >30 was significantly associated with an increased risk of lymphedema compared to a pre-operative BMI <25 and 25- <30 (p = 0.001 and p = 0.012, respectively). Patients with a pre-operative BMI 25- <30 were not at an increased risk of lymphedema compared to patients with a pre-operative BMI <25 (p = 0.409). Furthermore, a cumulative absolute weight fluctuation of 10 pounds gained/lost per month post-operatively significantly increased risk of lymphedema (HR: 1.97, p = < 0.0001). In conclusion, pre-operative BMI of ≥30 is an independent risk factor for lymphedema, whereas a BMI of 25- <30 is not. Large post-operative weight fluctuations also increase risk of lymphedema. Patients with a pre-operative BMI ≥30 and those who experience large weight fluctuations during and after treatment for breast cancer should be considered at higher-risk for lymphedema. Close monitoring or early intervention to ensure optimal treatment of the condition may be appropriate for these patients.
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Jammallo</name><affiliation wicri:level="2"><inist:fA14 i1="01"><s1>Department of Radiation Oncology, Massachusetts General Hospital, 100 Blossom Street</s1><s2>Boston, MA 02114</s2><s3>USA</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>5 aut.</sZ><sZ>8 aut.</sZ></inist:fA14><country>États-Unis</country><placeName><region type="state">Massachusetts</region></placeName></affiliation></author><author><name sortKey="Miller, Cynthia L" sort="Miller, Cynthia L" uniqKey="Miller C" first="Cynthia L." last="Miller">Cynthia L. Miller</name><affiliation wicri:level="2"><inist:fA14 i1="01"><s1>Department of Radiation Oncology, Massachusetts General Hospital, 100 Blossom Street</s1><s2>Boston, MA 02114</s2><s3>USA</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>5 aut.</sZ><sZ>8 aut.</sZ></inist:fA14><country>États-Unis</country><placeName><region type="state">Massachusetts</region></placeName></affiliation></author><author><name sortKey="Singer, Marybeth" sort="Singer, Marybeth" uniqKey="Singer M" first="Marybeth" last="Singer">Marybeth Singer</name><affiliation wicri:level="2"><inist:fA14 i1="02"><s1>Cancer Center, Tufts Medical Center</s1><s2>Boston, MA</s2><s3>USA</s3><sZ>3 aut.</sZ></inist:fA14><country>États-Unis</country><placeName><region type="state">Massachusetts</region></placeName></affiliation></author><author><name sortKey="Horick, Nora K" sort="Horick, Nora K" uniqKey="Horick N" first="Nora K." last="Horick">Nora K. Horick</name><affiliation wicri:level="2"><inist:fA14 i1="03"><s1>Biostatistics Center, Massachusetts General Hospital</s1><s2>Boston, MA</s2><s3>USA</s3><sZ>4 aut.</sZ></inist:fA14><country>États-Unis</country><placeName><region type="state">Massachusetts</region></placeName></affiliation></author><author><name sortKey="Skolny, Melissa N" sort="Skolny, Melissa N" uniqKey="Skolny M" first="Melissa N." last="Skolny">Melissa N. Skolny</name><affiliation wicri:level="2"><inist:fA14 i1="01"><s1>Department of Radiation Oncology, Massachusetts General Hospital, 100 Blossom Street</s1><s2>Boston, MA 02114</s2><s3>USA</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>5 aut.</sZ><sZ>8 aut.</sZ></inist:fA14><country>États-Unis</country><placeName><region type="state">Massachusetts</region></placeName></affiliation></author><author><name sortKey="Specht, Michelle C" sort="Specht, Michelle C" uniqKey="Specht M" first="Michelle C." last="Specht">Michelle C. Specht</name><affiliation wicri:level="2"><inist:fA14 i1="04"><s1>Division of Surgical Oncology, Massachusetts General Hospital</s1><s2>Boston, MA</s2><s3>USA</s3><sZ>6 aut.</sZ></inist:fA14><country>États-Unis</country><placeName><region type="state">Massachusetts</region></placeName></affiliation></author><author><name sortKey="O Toole, Jean" sort="O Toole, Jean" uniqKey="O Toole J" first="Jean" last="O'Toole">Jean O'Toole</name><affiliation wicri:level="2"><inist:fA14 i1="05"><s1>Department of Physical and Occupational Therapy, Massachusetts General Hospital</s1><s2>Boston, MA</s2><s3>USA</s3><sZ>7 aut.</sZ></inist:fA14><country>États-Unis</country><placeName><region type="state">Massachusetts</region></placeName></affiliation></author><author><name sortKey="Taghian, Alphonse G" sort="Taghian, Alphonse G" uniqKey="Taghian A" first="Alphonse G." last="Taghian">Alphonse G. Taghian</name><affiliation wicri:level="2"><inist:fA14 i1="01"><s1>Department of Radiation Oncology, Massachusetts General Hospital, 100 Blossom Street</s1><s2>Boston, MA 02114</s2><s3>USA</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>5 aut.</sZ><sZ>8 aut.</sZ></inist:fA14><country>États-Unis</country><placeName><region type="state">Massachusetts</region></placeName></affiliation></author></analytic><series><title level="j" type="main">Breast cancer research and treatment</title><title level="j" type="abbreviated">Breast cancer res. treat.</title><idno type="ISSN">0167-6806</idno><imprint><date when="2013">2013</date></imprint></series></biblStruct></sourceDesc><seriesStmt><title level="j" type="main">Breast cancer research and treatment</title><title level="j" type="abbreviated">Breast cancer res. treat.</title><idno type="ISSN">0167-6806</idno></seriesStmt></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Adult</term><term>Aged</term><term>Aged, 80 and over</term><term>Body Mass Index</term><term>Body Weight</term><term>Body mass index</term><term>Breast Neoplasms (complications)</term><term>Breast Neoplasms (surgery)</term><term>Breast cancer</term><term>Female</term><term>Fluctuations</term><term>Follow-Up Studies</term><term>Human</term><term>Humans</term><term>Lymphedema</term><term>Lymphedema (epidemiology)</term><term>Lymphedema (etiology)</term><term>Middle Aged</term><term>Postoperative Period</term><term>Preoperative Period</term><term>Risk</term><term>Risk factor</term><term>Treatment</term><term>Weight</term></keywords><keywords scheme="KwdFr" xml:lang="fr"><term>Adulte</term><term>Adulte d'âge moyen</term><term>Femelle</term><term>Humains</term><term>Indice de masse corporelle</term><term>Lymphoedème (épidémiologie)</term><term>Lymphoedème (étiologie)</term><term>Poids du corps</term><term>Période postopératoire</term><term>Période préopératoire</term><term>Risque</term><term>Sujet âgé</term><term>Sujet âgé de 80 ans ou plus</term><term>Tumeurs du sein ()</term><term>Études de suivi</term></keywords><keywords scheme="MESH" qualifier="complications" xml:lang="en"><term>Breast Neoplasms</term></keywords><keywords scheme="MESH" qualifier="epidemiology" xml:lang="en"><term>Lymphedema</term></keywords><keywords scheme="MESH" qualifier="etiology" xml:lang="en"><term>Lymphedema</term></keywords><keywords scheme="MESH" qualifier="surgery" xml:lang="en"><term>Breast Neoplasms</term></keywords><keywords scheme="MESH" qualifier="épidémiologie" xml:lang="fr"><term>Lymphoedème</term></keywords><keywords scheme="MESH" qualifier="étiologie" xml:lang="fr"><term>Lymphoedème</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Adult</term><term>Aged</term><term>Aged, 80 and over</term><term>Body Mass Index</term><term>Body Weight</term><term>Female</term><term>Follow-Up Studies</term><term>Humans</term><term>Middle Aged</term><term>Postoperative Period</term><term>Preoperative Period</term><term>Risk</term></keywords><keywords scheme="Pascal" xml:lang="fr"><term>Adulte</term><term>Adulte d'âge moyen</term><term>Femelle</term><term>Humains</term><term>Indice de masse corporelle</term><term>Indice masse corporelle</term><term>Poids</term><term>Fluctuation</term><term>Lymphoedème</term><term>Facteur risque</term><term>Homme</term><term>Poids du corps</term><term>Période postopératoire</term><term>Période préopératoire</term><term>Risque</term><term>Sujet âgé</term><term>Sujet âgé de 80 ans ou plus</term><term>Traitement</term><term>Cancer du sein</term><term>Tumeurs du sein</term><term>Études de suivi</term></keywords><keywords scheme="Wicri" type="topic" xml:lang="fr"><term>Homme</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">Identifying risk factors for lymphedema in patients treated for breast cancer has become increasingly important, given the current lack of standardization surrounding diagnosis and treatment. Reports on the association of body mass index (BMI) and weight change with lymphedema risk are conflicting. We sought to examine the impact of pre-operative BMI and post-treatment weight change on the incidence of lymphedema. From 2005 to 2011, 787 newly diagnosed breast cancer patients underwent prospective arm volume measurements with a Perometer pre- and post-operatively. BMI was calculated from same-day weight and height measurements. Lymphedema was defined as a relative volume change (RVC) of ≥ 10 %. Univariate and multivariate Cox proportional hazards models were used to evaluate the association between lymphedema risk and pre-operative BMI, weight change, and other demographic and treatment factors. By multivariate analysis, a pre-operative BMI >30 was significantly associated with an increased risk of lymphedema compared to a pre-operative BMI <25 and 25- <30 (p = 0.001 and p = 0.012, respectively). Patients with a pre-operative BMI 25- <30 were not at an increased risk of lymphedema compared to patients with a pre-operative BMI <25 (p = 0.409). Furthermore, a cumulative absolute weight fluctuation of 10 pounds gained/lost per month post-operatively significantly increased risk of lymphedema (HR: 1.97, p = < 0.0001). In conclusion, pre-operative BMI of ≥30 is an independent risk factor for lymphedema, whereas a BMI of 25- <30 is not. Large post-operative weight fluctuations also increase risk of lymphedema. Patients with a pre-operative BMI ≥30 and those who experience large weight fluctuations during and after treatment for breast cancer should be considered at higher-risk for lymphedema. Close monitoring or early intervention to ensure optimal treatment of the condition may be appropriate for these patients.</div></front></TEI><affiliations><list><country><li>États-Unis</li></country><region><li>Massachusetts</li></region></list><tree><country name="États-Unis"><region name="Massachusetts"><name sortKey="Jammallo, Lauren S" sort="Jammallo, Lauren S" uniqKey="Jammallo L" first="Lauren S." last="Jammallo">Lauren S. Jammallo</name></region><name sortKey="Horick, Nora K" sort="Horick, Nora K" uniqKey="Horick N" first="Nora K." last="Horick">Nora K. Horick</name><name sortKey="Miller, Cynthia L" sort="Miller, Cynthia L" uniqKey="Miller C" first="Cynthia L." last="Miller">Cynthia L. Miller</name><name sortKey="O Toole, Jean" sort="O Toole, Jean" uniqKey="O Toole J" first="Jean" last="O'Toole">Jean O'Toole</name><name sortKey="Singer, Marybeth" sort="Singer, Marybeth" uniqKey="Singer M" first="Marybeth" last="Singer">Marybeth Singer</name><name sortKey="Skolny, Melissa N" sort="Skolny, Melissa N" uniqKey="Skolny M" first="Melissa N." last="Skolny">Melissa N. Skolny</name><name sortKey="Specht, Michelle C" sort="Specht, Michelle C" uniqKey="Specht M" first="Michelle C." last="Specht">Michelle C. Specht</name><name sortKey="Taghian, Alphonse G" sort="Taghian, Alphonse G" uniqKey="Taghian A" first="Alphonse G." last="Taghian">Alphonse G. Taghian</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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