Risk Factors for Arm Lymphedema in a Cohort of Breast Cancer Patients Followed up for 10 Years
Identifieur interne : 000E95 ( Pmc/Checkpoint ); précédent : 000E94; suivant : 000E96Risk 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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PMC:4813649Le document en format XML
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<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>
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<author><name sortKey="Zucca Matthes, Gustavo" sort="Zucca Matthes, Gustavo" uniqKey="Zucca Matthes G" first="Gustavo" last="Zucca-Matthes">Gustavo Zucca-Matthes</name>
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<series><title level="j">Breast Care</title>
<idno type="ISSN">1661-3791</idno>
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<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>
<pmc article-type="research-article"><pmc-comment>The publisher of this article does not allow downloading of the full text in XML form.</pmc-comment>
<front><journal-meta><journal-id journal-id-type="nlm-ta">Breast Care (Basel)</journal-id>
<journal-id journal-id-type="iso-abbrev">Breast Care (Basel)</journal-id>
<journal-id journal-id-type="publisher-id">BRC</journal-id>
<journal-title-group><journal-title>Breast Care</journal-title>
</journal-title-group>
<issn pub-type="ppub">1661-3791</issn>
<issn pub-type="epub">1661-3805</issn>
<publisher><publisher-name>S. Karger Verlag für Medizin und Naturwissenschaften GmbH</publisher-name>
<publisher-loc>Wilhelmstrasse 20A, P.O. Box · Postfach · Case postale, D–79095, Freiburg, Germany · Deutschland · Allemagne, Phone: +49 761 45 20 70, Fax: +49 761 4 52 07 14, information@karger.de</publisher-loc>
</publisher>
</journal-meta>
<article-meta><article-id pub-id-type="pmid">27051396</article-id>
<article-id pub-id-type="pmc">4813649</article-id>
<article-id pub-id-type="doi">10.1159/000442489</article-id>
<article-id pub-id-type="publisher-id">brc-0011-0045</article-id>
<article-categories><subj-group subj-group-type="heading"><subject>Original Article</subject>
</subj-group>
</article-categories>
<title-group><article-title>Risk Factors for Arm Lymphedema in a Cohort of Breast Cancer Patients Followed up for 10 Years</article-title>
</title-group>
<contrib-group><contrib contrib-type="author"><name><surname>Vieira</surname>
<given-names>René Aloisio da Costa</given-names>
</name>
<xref ref-type="aff" rid="aff1">a</xref>
<xref ref-type="corresp" rid="cor1">*</xref>
</contrib>
<contrib contrib-type="author"><name><surname>da Costa</surname>
<given-names>Allini Mafra</given-names>
</name>
<xref ref-type="aff" rid="aff2">b</xref>
</contrib>
<contrib contrib-type="author"><name><surname>de Souza</surname>
<given-names>Josue Lopes</given-names>
</name>
<xref ref-type="aff" rid="aff1">a</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Coelho</surname>
<given-names>Rafael Richieri</given-names>
</name>
<xref ref-type="aff" rid="aff3">c</xref>
</contrib>
<contrib contrib-type="author"><name><surname>de Oliveira</surname>
<given-names>Cleyton Zanardo</given-names>
</name>
<xref ref-type="aff" rid="aff4">d</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Sarri</surname>
<given-names>Almir José</given-names>
</name>
<xref ref-type="aff" rid="aff3">c</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Junior</surname>
<given-names>Renato José Affonso</given-names>
</name>
<xref ref-type="aff" rid="aff5">e</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Zucca-Matthes</surname>
<given-names>Gustavo</given-names>
</name>
<xref ref-type="aff" rid="aff1">a</xref>
</contrib>
</contrib-group>
<aff id="aff1"><sup>a</sup>
Mastology and Breast Reconstruction Department, Barretos Cancer Hospital, Pio XII Foundation, Barretos, Brazil</aff>
<aff id="aff2"><sup>b</sup>
Hospital-based Cancer Registry, Barretos Cancer Hospital, Pio XII Foundation, Barretos, Brazil</aff>
<aff id="aff3"><sup>c</sup>
Department of Physiotherapy, Barretos Cancer Hospital, Pio XII Foundation, Barretos, Brazil</aff>
<aff id="aff4"><sup>d</sup>
Epidemiology and Biostatistics Nucleus, Barretos Cancer Hospital, Pio XII Foundation, Barretos, Brazil</aff>
<aff id="aff5"><sup>e</sup>
Department of Radiotherapy, Barretos Cancer Hospital, Pio XII Foundation, Barretos, Brazil</aff>
<author-notes><corresp id="cor1">*René Aloisio da Costa Vieira, MD, PhD, Mastology and Breast Reconstruction Department, Rua Antenor Duarte Villela, 1331, Bairro Dr Paulo Prata, 14.784.400 Barretos, SP, Brazil, <email>reneacv@gmail.com</email>
</corresp>
</author-notes>
<pub-date pub-type="ppub"><month>2</month>
<year>2016</year>
</pub-date>
<pub-date pub-type="epub"><day>14</day>
<month>12</month>
<year>2015</year>
</pub-date>
<pub-date pub-type="pmc-release"><day>1</day>
<month>2</month>
<year>2017</year>
</pub-date>
<pmc-comment> PMC Release delay is 12 months and
0 days and was based on the . </pmc-comment>
<volume>11</volume>
<issue>1</issue>
<fpage>45</fpage>
<lpage>50</lpage>
<permissions><copyright-statement>Copyright © 2016 by S. Karger Verlag für Medizin und Naturwissenschaften GmbH, Freiburg</copyright-statement>
<copyright-year>2016</copyright-year>
</permissions>
<abstract><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>
</abstract>
<kwd-group><title>Keywords</title>
<kwd>Breast cancer</kwd>
<kwd>Lymph node dissection</kwd>
<kwd>Radiotherapy</kwd>
<kwd>Risk factors</kwd>
<kwd>Lymphedema</kwd>
</kwd-group>
<counts><fig-count count="2"></fig-count>
<table-count count="3"></table-count>
<ref-count count="25"></ref-count>
<page-count count="6"></page-count>
</counts>
</article-meta>
</front>
</pmc>
<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>
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