LymphedemaV1, Pmc, Checkpoint, bibRecord, 003242

Risk Factors of Lymphedema in a Prospective Breast Cancer Survivorship Study: The Pathways Study

Identifieur interne : 003242 ( Pmc/Checkpoint ); précédent : 003241; suivant : 003243

Risk 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.

RBID : PMC:2997775

Abstract

Objective

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.

Design

The Pathways Study, a prospective cohort study of breast cancer survivors with a mean follow-up of 20.9 months.

Setting

Kaiser Permanente Northern California (KPNC) Medical Care Program.

Participants

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.

Main Outcome Measures

Clinical indication of BCRL as determined from outpatient or hospitalization diagnostic codes, outpatient procedural codes, and durable medical equipment orders.

Results

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).

Conclusions

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:

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2997775

DOI: 10.1001/archsurg.2010.231
PubMed: 21079093
PubMed Central: 2997775

Affiliations:

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PMC:2997775

Le document en format XML

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<author><name sortKey="Kwan, Marilyn L" sort="Kwan, Marilyn L" uniqKey="Kwan M" first="Marilyn L." last="Kwan">Marilyn L. Kwan</name>
<affiliation wicri:level="2"><nlm:aff id="A1"> Division of Research, Kaiser Permanente Northern California, Oakland, CA</nlm:aff>
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<sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">Risk Factors of Lymphedema in a Prospective Breast Cancer Survivorship Study: The Pathways Study</title>
<author><name sortKey="Kwan, Marilyn L" sort="Kwan, Marilyn L" uniqKey="Kwan M" first="Marilyn L." last="Kwan">Marilyn L. Kwan</name>
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<author><name sortKey="Darbinian, Jeanne" sort="Darbinian, Jeanne" uniqKey="Darbinian J" first="Jeanne" last="Darbinian">Jeanne Darbinian</name>
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<country xml:lang="fr">États-Unis</country>
<placeName><region type="state">Pennsylvanie</region>
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<country xml:lang="fr">États-Unis</country>
<placeName><region type="state">Californie</region>
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<wicri:cityArea> San Jose Medical Center, Kaiser Permanente Northern California, San Jose</wicri:cityArea>
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<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>
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<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>
<pmc article-type="research-article" xml:lang="EN"><pmc-comment>The publisher of this article does not allow downloading of the full text in XML form.</pmc-comment>
  <pmc-dir>properties manuscript</pmc-dir>
  <front><journal-meta><journal-id journal-id-type="nlm-journal-id">9716528</journal-id>
<journal-id journal-id-type="pubmed-jr-id">845</journal-id>
<journal-id journal-id-type="nlm-ta">Arch Surg</journal-id>
<journal-title>Archives of surgery (Chicago, Ill. : 1960)</journal-title>
<issn pub-type="ppub">0004-0010</issn>
<issn pub-type="epub">1538-3644</issn>
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<article-meta><article-id pub-id-type="pmid">21079093</article-id>
<article-id pub-id-type="pmc">2997775</article-id>
<article-id pub-id-type="doi">10.1001/archsurg.2010.231</article-id>
<article-id pub-id-type="manuscript">NIHMS252897</article-id>
<article-categories><subj-group subj-group-type="heading"><subject>Article</subject>
</subj-group>
</article-categories>
<title-group><article-title>Risk Factors of Lymphedema in a Prospective Breast Cancer Survivorship Study: The Pathways Study</article-title>
</title-group>
<contrib-group><contrib contrib-type="author"><name><surname>Kwan</surname>
<given-names>Marilyn L.</given-names>
</name>
<degrees>PhD</degrees>
<xref rid="A1" ref-type="aff">1</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Darbinian</surname>
<given-names>Jeanne</given-names>
</name>
<degrees>MS, RD</degrees>
<xref rid="A1" ref-type="aff">1</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Schmitz</surname>
<given-names>Kathryn H.</given-names>
</name>
<degrees>PhD</degrees>
<xref rid="A2" ref-type="aff">2</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Citron</surname>
<given-names>Rebecca</given-names>
</name>
<xref rid="A1" ref-type="aff">1</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Partee</surname>
<given-names>Paula</given-names>
</name>
<degrees>BA</degrees>
<xref rid="A1" ref-type="aff">1</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Kutner</surname>
<given-names>Susan E.</given-names>
</name>
<degrees>MD</degrees>
<xref rid="A3" ref-type="aff">3</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Kushi</surname>
<given-names>Lawrence H.</given-names>
</name>
<degrees>ScD</degrees>
<xref rid="A1" ref-type="aff">1</xref>
</contrib>
</contrib-group>
<aff id="A1"><label>1</label>
 Division of Research, Kaiser Permanente Northern California, Oakland, CA</aff>
<aff id="A2"><label>2</label>
 Department of Biostatistics and Epidemiology, University of Pennsylvania, Philadelphia, PA</aff>
<aff id="A3"><label>3</label>
 San Jose Medical Center, Kaiser Permanente Northern California, San Jose, CA</aff>
<author-notes><corresp id="FN1">Corresponding Author: Marilyn L. Kwan, PhD, 2000 Broadway, First Floor, Oakland, CA 94612, 510-891-3521 (phone), 510-891-3106 (fax), <email>Marilyn.L.Kwan@kp.org</email>
</corresp>
</author-notes>
<pub-date pub-type="nihms-submitted"><day>24</day>
<month>11</month>
<year>2010</year>
</pub-date>
<pub-date pub-type="ppub"><month>11</month>
<year>2010</year>
</pub-date>
<pub-date pub-type="pmc-release"><day>1</day>
<month>11</month>
<year>2011</year>
</pub-date>
<volume>145</volume>
<issue>11</issue>
<fpage>1055</fpage>
<lpage>1063</lpage>
<abstract><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>
</abstract>
<kwd-group><kwd>breast cancer</kwd>
<kwd>survivorship</kwd>
<kwd>lymphedema</kwd>
<kwd>risk factors</kwd>
<kwd>cohort study</kwd>
</kwd-group>
<contract-num rid="CA1">R01 CA105274-06
				||CA</contract-num>
<contract-sponsor id="CA1">National Cancer Institute : NCI</contract-sponsor>
</article-meta>
</front>
</pmc>
<affiliations><list><country><li>États-Unis</li>
</country>
<region><li>Californie</li>
<li>Pennsylvanie</li>
</region>
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<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>
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<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>

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Risk Factors of Lymphedema in a Prospective Breast Cancer Survivorship Study: The Pathways Study

Risk Factors of Lymphedema in a Prospective Breast Cancer Survivorship Study: The Pathways Study

Source :

Abstract

Links toward previous steps (curation, corpus...)

Links to Exploration step

Le document en format XML

Pour manipuler ce document sous Unix (Dilib)

Pour mettre un lien sur cette page dans le réseau Wicri

Pour générer des pages wiki