Risk Factors of Lymphedema in a Prospective Breast Cancer Survivorship Study: The Pathways Study
Identifieur interne : 005644 ( Main/Exploration ); précédent : 005643; suivant : 005645Risk Factors of Lymphedema in a Prospective Breast Cancer Survivorship Study: The Pathways Study
Auteurs : Marilyn L. Kwan [États-Unis] ; Jeanne Darbinian [États-Unis] ; Kathryn H. Schmitz [États-Unis] ; Rebecca Citron [États-Unis] ; Paula Partee [États-Unis] ; Susan E. Kutner [États-Unis] ; Lawrence H. Kushi [États-Unis]Source :
- Archives of surgery (Chicago, Ill. : 1960) [ 0004-0010 ] ; 2010.
Descripteurs français
- KwdFr :
- Adulte d'âge moyen, Californie (épidémiologie), Démographie, Facteurs de risque, Femelle, Humains, Incidence, Invasion tumorale, Loi du khi-deux, Lymphoedème (ethnologie), Lymphoedème (épidémiologie), Lymphoedème (étiologie), Mode de vie, Modèles de hasards proportionnels, Métastase lymphatique, Niveau d'instruction, Obésité (), Survivants (), Tumeurs du sein (), Tumeurs du sein (anatomopathologie), Tumeurs du sein (ethnologie), Études de suivi, Études prospectives.
- MESH :
- anatomopathologie : Tumeurs du sein.
- ethnologie : Lymphoedème, Tumeurs du sein.
- épidémiologie : Californie, Lymphoedème.
- étiologie : Lymphoedème.
- Adulte d'âge moyen, Démographie, Facteurs de risque, Femelle, Humains, Incidence, Invasion tumorale, Loi du khi-deux, Mode de vie, Modèles de hasards proportionnels, Métastase lymphatique, Niveau d'instruction, Obésité, Survivants, Tumeurs du sein, Études de suivi, Études prospectives.
English descriptors
- KwdEn :
- Breast Neoplasms (ethnology), Breast Neoplasms (pathology), Breast Neoplasms (surgery), California (epidemiology), Chi-Square Distribution, Demography, Educational Status, Female, Follow-Up Studies, Humans, Incidence, Life Style, Lymphatic Metastasis, Lymphedema (epidemiology), Lymphedema (ethnology), Lymphedema (etiology), Middle Aged, Neoplasm Invasiveness, Obesity (complications), Proportional Hazards Models, Prospective Studies, Risk Factors, Survivors (statistics & numerical data).
- MESH :
- geographic , epidemiology : California.
- complications : Obesity.
- epidemiology : Lymphedema.
- ethnology : Breast Neoplasms, Lymphedema.
- etiology : Lymphedema.
- pathology : Breast Neoplasms.
- statistics & numerical data : Survivors.
- surgery : Breast Neoplasms.
- Chi-Square Distribution, Demography, Educational Status, Female, Follow-Up Studies, Humans, Incidence, Life Style, Lymphatic Metastasis, Middle Aged, Neoplasm Invasiveness, Proportional Hazards Models, Prospective Studies, Risk Factors.
Abstract
To determine the incidence of breast cancer-related lymphedema (BCRL) during the early survivorship period, and demographic, lifestyle, and clinical factors associated with BCRL development.
The Pathways Study, a prospective cohort study of breast cancer survivors with a mean follow-up of 20.9 months.
Kaiser Permanente Northern California (KPNC) Medical Care Program.
997 women diagnosed from January 2006 to October 2007 with primary invasive breast cancer and at least 21 years of age at diagnosis, had no prior history of any cancer, and spoke English, Spanish, or Chinese.
Clinical indication of BCRL as determined from outpatient or hospitalization diagnostic codes, outpatient procedural codes, and durable medical equipment orders.
133 women (13.3%) had a clinical indication of BCRL, with a mean time to diagnosis of 8.3 months (range: 0.7–27.3). Being African American (HR = 1.93; 95% CI: 1.00–3.72) or more educated (p trend = 0.03) was associated with an increased risk of BCRL. Removal of at least one lymph node (HR = 1.04; 95% CI: 1.02–1.07) was associated with increased risk, yet no significant association was observed for type of lymph node surgery. Being obese at breast cancer diagnosis was suggestive of an elevated risk (HR = 1.43; 95% CI: 0.88–2.31).
In a large cohort study, BCRL occurs among a substantial proportion of early breast cancer survivors. Our findings agree with previous studies on the increased risk of BCRL with removal of lymph nodes and being obese, yet point to differential risk by race/ethnicity.
Url:
DOI: 10.1001/archsurg.2010.231
PubMed: 21079093
PubMed Central: 2997775
Affiliations:
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Kwan</name><affiliation wicri:level="2"><nlm:aff id="A1"> Division of Research, Kaiser Permanente Northern California, Oakland, CA</nlm:aff><country xml:lang="fr">États-Unis</country><placeName><region type="state">Californie</region></placeName><wicri:cityArea> Division of Research, Kaiser Permanente Northern California, Oakland</wicri:cityArea></affiliation></author><author><name sortKey="Darbinian, Jeanne" sort="Darbinian, Jeanne" uniqKey="Darbinian J" first="Jeanne" last="Darbinian">Jeanne Darbinian</name><affiliation wicri:level="2"><nlm:aff id="A1"> Division of Research, Kaiser Permanente Northern California, Oakland, CA</nlm:aff><country xml:lang="fr">États-Unis</country><placeName><region type="state">Californie</region></placeName><wicri:cityArea> Division of Research, Kaiser Permanente Northern California, Oakland</wicri:cityArea></affiliation></author><author><name sortKey="Schmitz, Kathryn H" sort="Schmitz, Kathryn H" uniqKey="Schmitz K" first="Kathryn H." last="Schmitz">Kathryn H. Schmitz</name><affiliation wicri:level="2"><nlm:aff id="A2"> Department of Biostatistics and Epidemiology, University of Pennsylvania, Philadelphia, PA</nlm:aff><country xml:lang="fr">États-Unis</country><placeName><region type="state">Pennsylvanie</region></placeName><wicri:cityArea> Department of Biostatistics and Epidemiology, University of Pennsylvania, Philadelphia</wicri:cityArea></affiliation></author><author><name sortKey="Citron, Rebecca" sort="Citron, Rebecca" uniqKey="Citron R" first="Rebecca" last="Citron">Rebecca Citron</name><affiliation wicri:level="2"><nlm:aff id="A1"> Division of Research, Kaiser Permanente Northern California, Oakland, CA</nlm:aff><country xml:lang="fr">États-Unis</country><placeName><region type="state">Californie</region></placeName><wicri:cityArea> Division of Research, Kaiser Permanente Northern California, Oakland</wicri:cityArea></affiliation></author><author><name sortKey="Partee, Paula" sort="Partee, Paula" uniqKey="Partee P" first="Paula" last="Partee">Paula Partee</name><affiliation wicri:level="2"><nlm:aff id="A1"> Division of Research, Kaiser Permanente Northern California, Oakland, CA</nlm:aff><country xml:lang="fr">États-Unis</country><placeName><region type="state">Californie</region></placeName><wicri:cityArea> Division of Research, Kaiser Permanente Northern California, Oakland</wicri:cityArea></affiliation></author><author><name sortKey="Kutner, Susan E" sort="Kutner, Susan E" uniqKey="Kutner S" first="Susan E." last="Kutner">Susan E. Kutner</name><affiliation wicri:level="2"><nlm:aff id="A3"> San Jose Medical Center, Kaiser Permanente Northern California, San Jose, CA</nlm:aff><country xml:lang="fr">États-Unis</country><placeName><region type="state">Californie</region></placeName><wicri:cityArea> San Jose Medical Center, Kaiser Permanente Northern California, San Jose</wicri:cityArea></affiliation></author><author><name sortKey="Kushi, Lawrence H" sort="Kushi, Lawrence H" uniqKey="Kushi L" first="Lawrence H." last="Kushi">Lawrence H. Kushi</name><affiliation wicri:level="2"><nlm:aff id="A1"> Division of Research, Kaiser Permanente Northern California, Oakland, CA</nlm:aff><country xml:lang="fr">États-Unis</country><placeName><region type="state">Californie</region></placeName><wicri:cityArea> Division of Research, Kaiser Permanente Northern California, Oakland</wicri:cityArea></affiliation></author></analytic><series><title level="j">Archives of surgery (Chicago, Ill. : 1960)</title><idno type="ISSN">0004-0010</idno><idno type="eISSN">1538-3644</idno><imprint><date when="2010">2010</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Breast Neoplasms (ethnology)</term><term>Breast Neoplasms (pathology)</term><term>Breast Neoplasms (surgery)</term><term>California (epidemiology)</term><term>Chi-Square Distribution</term><term>Demography</term><term>Educational Status</term><term>Female</term><term>Follow-Up Studies</term><term>Humans</term><term>Incidence</term><term>Life Style</term><term>Lymphatic Metastasis</term><term>Lymphedema (epidemiology)</term><term>Lymphedema (ethnology)</term><term>Lymphedema (etiology)</term><term>Middle Aged</term><term>Neoplasm Invasiveness</term><term>Obesity (complications)</term><term>Proportional Hazards Models</term><term>Prospective Studies</term><term>Risk Factors</term><term>Survivors (statistics & numerical data)</term></keywords><keywords scheme="KwdFr" xml:lang="fr"><term>Adulte d'âge moyen</term><term>Californie (épidémiologie)</term><term>Démographie</term><term>Facteurs de risque</term><term>Femelle</term><term>Humains</term><term>Incidence</term><term>Invasion tumorale</term><term>Loi du khi-deux</term><term>Lymphoedème (ethnologie)</term><term>Lymphoedème (épidémiologie)</term><term>Lymphoedème (étiologie)</term><term>Mode de vie</term><term>Modèles de hasards proportionnels</term><term>Métastase lymphatique</term><term>Niveau d'instruction</term><term>Obésité ()</term><term>Survivants ()</term><term>Tumeurs du sein ()</term><term>Tumeurs du sein (anatomopathologie)</term><term>Tumeurs du sein (ethnologie)</term><term>Études de suivi</term><term>Études prospectives</term></keywords><keywords scheme="MESH" type="geographic" qualifier="epidemiology" xml:lang="en"><term>California</term></keywords><keywords scheme="MESH" qualifier="anatomopathologie" xml:lang="fr"><term>Tumeurs du sein</term></keywords><keywords scheme="MESH" qualifier="complications" xml:lang="en"><term>Obesity</term></keywords><keywords scheme="MESH" qualifier="epidemiology" xml:lang="en"><term>Lymphedema</term></keywords><keywords scheme="MESH" qualifier="ethnologie" xml:lang="fr"><term>Lymphoedème</term><term>Tumeurs du sein</term></keywords><keywords scheme="MESH" qualifier="ethnology" xml:lang="en"><term>Breast Neoplasms</term><term>Lymphedema</term></keywords><keywords scheme="MESH" qualifier="etiology" xml:lang="en"><term>Lymphedema</term></keywords><keywords scheme="MESH" qualifier="pathology" xml:lang="en"><term>Breast Neoplasms</term></keywords><keywords scheme="MESH" qualifier="statistics & numerical data" xml:lang="en"><term>Survivors</term></keywords><keywords scheme="MESH" qualifier="surgery" xml:lang="en"><term>Breast Neoplasms</term></keywords><keywords scheme="MESH" qualifier="épidémiologie" xml:lang="fr"><term>Californie</term><term>Lymphoedème</term></keywords><keywords scheme="MESH" qualifier="étiologie" xml:lang="fr"><term>Lymphoedème</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Chi-Square Distribution</term><term>Demography</term><term>Educational Status</term><term>Female</term><term>Follow-Up Studies</term><term>Humans</term><term>Incidence</term><term>Life Style</term><term>Lymphatic Metastasis</term><term>Middle Aged</term><term>Neoplasm Invasiveness</term><term>Proportional Hazards Models</term><term>Prospective Studies</term><term>Risk Factors</term></keywords><keywords scheme="MESH" xml:lang="fr"><term>Adulte d'âge moyen</term><term>Démographie</term><term>Facteurs de risque</term><term>Femelle</term><term>Humains</term><term>Incidence</term><term>Invasion tumorale</term><term>Loi du khi-deux</term><term>Mode de vie</term><term>Modèles de hasards proportionnels</term><term>Métastase lymphatique</term><term>Niveau d'instruction</term><term>Obésité</term><term>Survivants</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>Objective</title><p id="P1">To determine the incidence of breast cancer-related lymphedema (BCRL) during the early survivorship period, and demographic, lifestyle, and clinical factors associated with BCRL development.</p></sec><sec id="S2"><title>Design</title><p id="P2">The Pathways Study, a prospective cohort study of breast cancer survivors with a mean follow-up of 20.9 months.</p></sec><sec id="S3"><title>Setting</title><p id="P3">Kaiser Permanente Northern California (KPNC) Medical Care Program.</p></sec><sec id="S4"><title>Participants</title><p id="P4">997 women diagnosed from January 2006 to October 2007 with primary invasive breast cancer and at least 21 years of age at diagnosis, had no prior history of any cancer, and spoke English, Spanish, or Chinese.</p></sec><sec id="S5"><title>Main Outcome Measures</title><p id="P5">Clinical indication of BCRL as determined from outpatient or hospitalization diagnostic codes, outpatient procedural codes, and durable medical equipment orders.</p></sec><sec id="S6"><title>Results</title><p id="P6">133 women (13.3%) had a clinical indication of BCRL, with a mean time to diagnosis of 8.3 months (range: 0.7–27.3). Being African American (HR = 1.93; 95% CI: 1.00–3.72) or more educated (p trend = 0.03) was associated with an increased risk of BCRL. Removal of at least one lymph node (HR = 1.04; 95% CI: 1.02–1.07) was associated with increased risk, yet no significant association was observed for type of lymph node surgery. Being obese at breast cancer diagnosis was suggestive of an elevated risk (HR = 1.43; 95% CI: 0.88–2.31).</p></sec><sec id="S7"><title>Conclusions</title><p id="P7">In a large cohort study, BCRL occurs among a substantial proportion of early breast cancer survivors. Our findings agree with previous studies on the increased risk of BCRL with removal of lymph nodes and being obese, yet point to differential risk by race/ethnicity.</p></sec></div></front></TEI><affiliations><list><country><li>États-Unis</li></country><region><li>Californie</li><li>Pennsylvanie</li></region></list><tree><country name="États-Unis"><region name="Californie"><name sortKey="Kwan, Marilyn L" sort="Kwan, Marilyn L" uniqKey="Kwan M" first="Marilyn L." last="Kwan">Marilyn L. Kwan</name></region><name sortKey="Citron, Rebecca" sort="Citron, Rebecca" uniqKey="Citron R" first="Rebecca" last="Citron">Rebecca Citron</name><name sortKey="Darbinian, Jeanne" sort="Darbinian, Jeanne" uniqKey="Darbinian J" first="Jeanne" last="Darbinian">Jeanne Darbinian</name><name sortKey="Kushi, Lawrence H" sort="Kushi, Lawrence H" uniqKey="Kushi L" first="Lawrence H." last="Kushi">Lawrence H. Kushi</name><name sortKey="Kutner, Susan E" sort="Kutner, Susan E" uniqKey="Kutner S" first="Susan E." last="Kutner">Susan E. Kutner</name><name sortKey="Partee, Paula" sort="Partee, Paula" uniqKey="Partee P" first="Paula" last="Partee">Paula Partee</name><name sortKey="Schmitz, Kathryn H" sort="Schmitz, Kathryn H" uniqKey="Schmitz K" first="Kathryn H." last="Schmitz">Kathryn H. Schmitz</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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