Risk factors for lymphoedema in women with breast cancer: A large prospective cohort.
Identifieur interne : 000821 ( PubMed/Corpus ); précédent : 000820; suivant : 000822Risk factors for lymphoedema in women with breast cancer: A large prospective cohort.
Auteurs : S L Kilbreath ; K M Refshauge ; J M Beith ; L C Ward ; O A Ung ; E S Dylke ; J R French ; J. Yee ; L. Koelmeyer ; K. GaitatzisSource :
- Breast (Edinburgh, Scotland) [ 1532-3080 ] ; 2016.
English descriptors
- KwdEn :
- Adult, Aged, Antineoplastic Combined Chemotherapy Protocols (adverse effects), Arm, Axilla, Body Weight, Breast Neoplasms (pathology), Breast Neoplasms (therapy), Bridged-Ring Compounds (administration & dosage), Female, Follow-Up Studies, Humans, Lymph Node Excision (adverse effects), Lymphatic Metastasis, Lymphedema (diagnosis), Lymphedema (etiology), Mastectomy (adverse effects), Middle Aged, Phlebotomy (adverse effects), Postoperative Complications (etiology), Prospective Studies, Radiotherapy (adverse effects), Risk Factors, Taxoids (administration & dosage), Time Factors.
- MESH :
- chemical , administration & dosage : Bridged-Ring Compounds, Taxoids.
- adverse effects : Antineoplastic Combined Chemotherapy Protocols, Lymph Node Excision, Mastectomy, Phlebotomy, Radiotherapy.
- diagnosis : Lymphedema.
- etiology : Lymphedema, Postoperative Complications.
- pathology : Breast Neoplasms.
- therapy : Breast Neoplasms.
- Adult, Aged, Arm, Axilla, Body Weight, Female, Follow-Up Studies, Humans, Lymphatic Metastasis, Middle Aged, Prospective Studies, Risk Factors, Time Factors.
Abstract
A prospective study was conducted to identify women at increased risk for lymphoedema (LE) based on axillary surgery. Assessment occurred prior to surgery, within 4 weeks, and at 6, 12 and 18 months following surgery. Following post-surgery assessment, women were asked to complete weekly diaries regarding events that occurred in the previous week. Risk factors were grouped into demographic, lifestyle, breast cancer treatment-related, arm swelling-related, and post-surgical activities. Bioimpedance spectroscopy thresholds were used to determine presence of LE. At 18-months, 241 women with <5 nodes removed and 209 women with ≥5 nodes removed were assessed. For those with <5 nodes removed, LE was present in 3.3% compared with 18.2% for those with ≥5 nodes removed. There were insufficient events to identify risk factors for those with <5 nodes removed; for those with >5 nodes removed, independent risk factors included presence of arm swelling at 12-months (Odds Ratio (OR): 13.5, 95% CI 4.8, 38.1; P < 0.01), at 6-months (5.6 (2.0, 16.9); P < 0.01), and radiotherapy to the axilla (2.6 (0.7, 8.9); P = 0.14). Arm swelling at 6 and 12 months was associated with taxane-based chemotherapy, high body weight at diagnosis and arm swelling within 4 weeks post-surgery. Of the post-surgical events assessed in a sub-group of women with >5 nodes removed and who maintained weekly diaries, only blood drawn from the 'at-risk' arm was identified as a potential risk (OR 2.0; 0.8, 5.2). For women with ≥5 nodes removed, arm swelling in the first year poses a very strong risk for presence of LE at 18-months.
DOI: 10.1016/j.breast.2016.04.011
PubMed: 27183497
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pubmed:27183497Le document en format XML
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Electronic address: sharon.kilbreath@sydney.edu.au.</nlm:affiliation></affiliation></author><author><name sortKey="Refshauge, K M" sort="Refshauge, K M" uniqKey="Refshauge K" first="K M" last="Refshauge">K M Refshauge</name><affiliation><nlm:affiliation>Faculty of Health Sciences, University of Sydney, Sydney, Australia.</nlm:affiliation></affiliation></author><author><name sortKey="Beith, J M" sort="Beith, J M" uniqKey="Beith J" first="J M" last="Beith">J M Beith</name><affiliation><nlm:affiliation>Chris O'Brien Lifehouse, Camperdown, Australia.</nlm:affiliation></affiliation></author><author><name sortKey="Ward, L C" sort="Ward, L C" uniqKey="Ward L" first="L C" last="Ward">L C Ward</name><affiliation><nlm:affiliation>Faculty of Health Sciences, University of Sydney, Sydney, Australia; School of Chemistry and Molecular Biosciences, The University of Queensland, Brisbane, Australia.</nlm:affiliation></affiliation></author><author><name sortKey="Ung, O A" sort="Ung, O A" uniqKey="Ung O" first="O A" last="Ung">O A Ung</name><affiliation><nlm:affiliation>Royal Brisbane and Women's Hospital, School of Medicine, The University of Queensland, Brisbane, Australia.</nlm:affiliation></affiliation></author><author><name sortKey="Dylke, E S" sort="Dylke, E S" uniqKey="Dylke E" first="E S" last="Dylke">E S Dylke</name><affiliation><nlm:affiliation>Faculty of Health Sciences, University of Sydney, Sydney, Australia.</nlm:affiliation></affiliation></author><author><name sortKey="French, J R" sort="French, J R" uniqKey="French J" first="J R" last="French">J R French</name><affiliation><nlm:affiliation>Westmead Breast Cancer Institute, Westmead Hospital, Westmead, Australia.</nlm:affiliation></affiliation></author><author><name sortKey="Yee, J" sort="Yee, J" uniqKey="Yee J" first="J" last="Yee">J. 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Gaitatzis</name><affiliation><nlm:affiliation>Faculty of Health Sciences, University of Sydney, Sydney, Australia.</nlm:affiliation></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PubMed</idno><date when="2016">2016</date><idno type="RBID">pubmed:27183497</idno><idno type="pmid">27183497</idno><idno type="doi">10.1016/j.breast.2016.04.011</idno><idno type="wicri:Area/PubMed/Corpus">000821</idno><idno type="wicri:explorRef" wicri:stream="PubMed" wicri:step="Corpus" wicri:corpus="PubMed">000821</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en">Risk factors for lymphoedema in women with breast cancer: A large prospective cohort.</title><author><name sortKey="Kilbreath, S L" sort="Kilbreath, S L" uniqKey="Kilbreath S" first="S L" last="Kilbreath">S L Kilbreath</name><affiliation><nlm:affiliation>Faculty of Health Sciences, University of Sydney, Sydney, Australia. Electronic address: sharon.kilbreath@sydney.edu.au.</nlm:affiliation></affiliation></author><author><name sortKey="Refshauge, K M" sort="Refshauge, K M" uniqKey="Refshauge K" first="K M" last="Refshauge">K M Refshauge</name><affiliation><nlm:affiliation>Faculty of Health Sciences, University of Sydney, Sydney, Australia.</nlm:affiliation></affiliation></author><author><name sortKey="Beith, J M" sort="Beith, J M" uniqKey="Beith J" first="J M" last="Beith">J M Beith</name><affiliation><nlm:affiliation>Chris O'Brien Lifehouse, Camperdown, Australia.</nlm:affiliation></affiliation></author><author><name sortKey="Ward, L C" sort="Ward, L C" uniqKey="Ward L" first="L C" last="Ward">L C Ward</name><affiliation><nlm:affiliation>Faculty of Health Sciences, University of Sydney, Sydney, Australia; School of Chemistry and Molecular Biosciences, The University of Queensland, Brisbane, Australia.</nlm:affiliation></affiliation></author><author><name sortKey="Ung, O A" sort="Ung, O A" uniqKey="Ung O" first="O A" last="Ung">O A Ung</name><affiliation><nlm:affiliation>Royal Brisbane and Women's Hospital, School of Medicine, The University of Queensland, Brisbane, Australia.</nlm:affiliation></affiliation></author><author><name sortKey="Dylke, E S" sort="Dylke, E S" uniqKey="Dylke E" first="E S" last="Dylke">E S Dylke</name><affiliation><nlm:affiliation>Faculty of Health Sciences, University of Sydney, Sydney, Australia.</nlm:affiliation></affiliation></author><author><name sortKey="French, J R" sort="French, J R" uniqKey="French J" first="J R" last="French">J R French</name><affiliation><nlm:affiliation>Westmead Breast Cancer Institute, Westmead Hospital, Westmead, Australia.</nlm:affiliation></affiliation></author><author><name sortKey="Yee, J" sort="Yee, J" uniqKey="Yee J" first="J" last="Yee">J. Yee</name><affiliation><nlm:affiliation>Faculty of Health Sciences, University of Sydney, Sydney, Australia.</nlm:affiliation></affiliation></author><author><name sortKey="Koelmeyer, L" sort="Koelmeyer, L" uniqKey="Koelmeyer L" first="L" last="Koelmeyer">L. Koelmeyer</name><affiliation><nlm:affiliation>Westmead Breast Cancer Institute, Westmead Hospital, Westmead, Australia.</nlm:affiliation></affiliation></author><author><name sortKey="Gaitatzis, K" sort="Gaitatzis, K" uniqKey="Gaitatzis K" first="K" last="Gaitatzis">K. Gaitatzis</name><affiliation><nlm:affiliation>Faculty of Health Sciences, University of Sydney, Sydney, Australia.</nlm:affiliation></affiliation></author></analytic><series><title level="j">Breast (Edinburgh, Scotland)</title><idno type="eISSN">1532-3080</idno><imprint><date when="2016" type="published">2016</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Adult</term><term>Aged</term><term>Antineoplastic Combined Chemotherapy Protocols (adverse effects)</term><term>Arm</term><term>Axilla</term><term>Body Weight</term><term>Breast Neoplasms (pathology)</term><term>Breast Neoplasms (therapy)</term><term>Bridged-Ring Compounds (administration & dosage)</term><term>Female</term><term>Follow-Up Studies</term><term>Humans</term><term>Lymph Node Excision (adverse effects)</term><term>Lymphatic Metastasis</term><term>Lymphedema (diagnosis)</term><term>Lymphedema (etiology)</term><term>Mastectomy (adverse effects)</term><term>Middle Aged</term><term>Phlebotomy (adverse effects)</term><term>Postoperative Complications (etiology)</term><term>Prospective Studies</term><term>Radiotherapy (adverse effects)</term><term>Risk Factors</term><term>Taxoids (administration & dosage)</term><term>Time Factors</term></keywords><keywords scheme="MESH" type="chemical" qualifier="administration & dosage" xml:lang="en"><term>Bridged-Ring Compounds</term><term>Taxoids</term></keywords><keywords scheme="MESH" qualifier="adverse effects" xml:lang="en"><term>Antineoplastic Combined Chemotherapy Protocols</term><term>Lymph Node Excision</term><term>Mastectomy</term><term>Phlebotomy</term><term>Radiotherapy</term></keywords><keywords scheme="MESH" qualifier="diagnosis" xml:lang="en"><term>Lymphedema</term></keywords><keywords scheme="MESH" qualifier="etiology" xml:lang="en"><term>Lymphedema</term><term>Postoperative Complications</term></keywords><keywords scheme="MESH" qualifier="pathology" xml:lang="en"><term>Breast Neoplasms</term></keywords><keywords scheme="MESH" qualifier="therapy" xml:lang="en"><term>Breast Neoplasms</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Adult</term><term>Aged</term><term>Arm</term><term>Axilla</term><term>Body Weight</term><term>Female</term><term>Follow-Up Studies</term><term>Humans</term><term>Lymphatic Metastasis</term><term>Middle Aged</term><term>Prospective Studies</term><term>Risk Factors</term><term>Time Factors</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">A prospective study was conducted to identify women at increased risk for lymphoedema (LE) based on axillary surgery. Assessment occurred prior to surgery, within 4 weeks, and at 6, 12 and 18 months following surgery. Following post-surgery assessment, women were asked to complete weekly diaries regarding events that occurred in the previous week. Risk factors were grouped into demographic, lifestyle, breast cancer treatment-related, arm swelling-related, and post-surgical activities. Bioimpedance spectroscopy thresholds were used to determine presence of LE. At 18-months, 241 women with <5 nodes removed and 209 women with ≥5 nodes removed were assessed. For those with <5 nodes removed, LE was present in 3.3% compared with 18.2% for those with ≥5 nodes removed. There were insufficient events to identify risk factors for those with <5 nodes removed; for those with >5 nodes removed, independent risk factors included presence of arm swelling at 12-months (Odds Ratio (OR): 13.5, 95% CI 4.8, 38.1; P < 0.01), at 6-months (5.6 (2.0, 16.9); P < 0.01), and radiotherapy to the axilla (2.6 (0.7, 8.9); P = 0.14). Arm swelling at 6 and 12 months was associated with taxane-based chemotherapy, high body weight at diagnosis and arm swelling within 4 weeks post-surgery. Of the post-surgical events assessed in a sub-group of women with >5 nodes removed and who maintained weekly diaries, only blood drawn from the 'at-risk' arm was identified as a potential risk (OR 2.0; 0.8, 5.2). For women with ≥5 nodes removed, arm swelling in the first year poses a very strong risk for presence of LE at 18-months.</div></front></TEI><pubmed><MedlineCitation Status="MEDLINE" Owner="NLM"><PMID Version="1">27183497</PMID><DateCreated><Year>2016</Year><Month>07</Month><Day>12</Day></DateCreated><DateCompleted><Year>2017</Year><Month>03</Month><Day>13</Day></DateCompleted><DateRevised><Year>2017</Year><Month>03</Month><Day>13</Day></DateRevised><Article PubModel="Print-Electronic"><Journal><ISSN IssnType="Electronic">1532-3080</ISSN><JournalIssue CitedMedium="Internet"><Volume>28</Volume><PubDate><Year>2016</Year><Month>Aug</Month></PubDate></JournalIssue><Title>Breast (Edinburgh, Scotland)</Title><ISOAbbreviation>Breast</ISOAbbreviation></Journal><ArticleTitle>Risk factors for lymphoedema in women with breast cancer: A large prospective cohort.</ArticleTitle><Pagination><MedlinePgn>29-36</MedlinePgn></Pagination><ELocationID EIdType="doi" ValidYN="Y">10.1016/j.breast.2016.04.011</ELocationID><ELocationID EIdType="pii" ValidYN="Y">S0960-9776(16)30041-8</ELocationID><Abstract><AbstractText>A prospective study was conducted to identify women at increased risk for lymphoedema (LE) based on axillary surgery. Assessment occurred prior to surgery, within 4 weeks, and at 6, 12 and 18 months following surgery. Following post-surgery assessment, women were asked to complete weekly diaries regarding events that occurred in the previous week. Risk factors were grouped into demographic, lifestyle, breast cancer treatment-related, arm swelling-related, and post-surgical activities. Bioimpedance spectroscopy thresholds were used to determine presence of LE. At 18-months, 241 women with <5 nodes removed and 209 women with ≥5 nodes removed were assessed. For those with <5 nodes removed, LE was present in 3.3% compared with 18.2% for those with ≥5 nodes removed. There were insufficient events to identify risk factors for those with <5 nodes removed; for those with >5 nodes removed, independent risk factors included presence of arm swelling at 12-months (Odds Ratio (OR): 13.5, 95% CI 4.8, 38.1; P < 0.01), at 6-months (5.6 (2.0, 16.9); P < 0.01), and radiotherapy to the axilla (2.6 (0.7, 8.9); P = 0.14). Arm swelling at 6 and 12 months was associated with taxane-based chemotherapy, high body weight at diagnosis and arm swelling within 4 weeks post-surgery. Of the post-surgical events assessed in a sub-group of women with >5 nodes removed and who maintained weekly diaries, only blood drawn from the 'at-risk' arm was identified as a potential risk (OR 2.0; 0.8, 5.2). For women with ≥5 nodes removed, arm swelling in the first year poses a very strong risk for presence of LE at 18-months.</AbstractText><CopyrightInformation>Copyright © 2016 Elsevier Ltd. All rights reserved.</CopyrightInformation></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Kilbreath</LastName><ForeName>S L</ForeName><Initials>SL</Initials><AffiliationInfo><Affiliation>Faculty of Health Sciences, University of Sydney, Sydney, Australia. Electronic address: sharon.kilbreath@sydney.edu.au.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Refshauge</LastName><ForeName>K M</ForeName><Initials>KM</Initials><AffiliationInfo><Affiliation>Faculty of Health Sciences, University of Sydney, Sydney, Australia.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Beith</LastName><ForeName>J M</ForeName><Initials>JM</Initials><AffiliationInfo><Affiliation>Chris O'Brien Lifehouse, Camperdown, Australia.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Ward</LastName><ForeName>L C</ForeName><Initials>LC</Initials><AffiliationInfo><Affiliation>Faculty of Health Sciences, University of Sydney, Sydney, Australia; School of Chemistry and Molecular Biosciences, The University of Queensland, Brisbane, Australia.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Ung</LastName><ForeName>O A</ForeName><Initials>OA</Initials><AffiliationInfo><Affiliation>Royal Brisbane and Women's Hospital, School of Medicine, The University of Queensland, Brisbane, Australia.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Dylke</LastName><ForeName>E S</ForeName><Initials>ES</Initials><AffiliationInfo><Affiliation>Faculty of Health Sciences, University of Sydney, Sydney, Australia.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>French</LastName><ForeName>J R</ForeName><Initials>JR</Initials><AffiliationInfo><Affiliation>Westmead Breast Cancer Institute, Westmead Hospital, Westmead, Australia.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Yee</LastName><ForeName>J</ForeName><Initials>J</Initials><AffiliationInfo><Affiliation>Faculty of Health Sciences, University of Sydney, Sydney, Australia.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Koelmeyer</LastName><ForeName>L</ForeName><Initials>L</Initials><AffiliationInfo><Affiliation>Westmead Breast Cancer Institute, Westmead Hospital, Westmead, Australia.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Gaitatzis</LastName><ForeName>K</ForeName><Initials>K</Initials><AffiliationInfo><Affiliation>Faculty of Health Sciences, University of Sydney, Sydney, Australia.</Affiliation></AffiliationInfo></Author></AuthorList><Language>eng</Language><PublicationTypeList><PublicationType UI="D016428">Journal Article</PublicationType></PublicationTypeList><ArticleDate DateType="Electronic"><Year>2016</Year><Month>05</Month><Day>13</Day></ArticleDate></Article><MedlineJournalInfo><Country>Netherlands</Country><MedlineTA>Breast</MedlineTA><NlmUniqueID>9213011</NlmUniqueID><ISSNLinking>0960-9776</ISSNLinking></MedlineJournalInfo><ChemicalList><Chemical><RegistryNumber>0</RegistryNumber><NameOfSubstance UI="D001952">Bridged-Ring Compounds</NameOfSubstance></Chemical><Chemical><RegistryNumber>0</RegistryNumber><NameOfSubstance UI="D043823">Taxoids</NameOfSubstance></Chemical><Chemical><RegistryNumber>1605-68-1</RegistryNumber><NameOfSubstance UI="C080625">taxane</NameOfSubstance></Chemical></ChemicalList><CitationSubset>IM</CitationSubset><MeshHeadingList><MeshHeading><DescriptorName UI="D000328" MajorTopicYN="N">Adult</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D000368" MajorTopicYN="N">Aged</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D000971" MajorTopicYN="N">Antineoplastic Combined Chemotherapy Protocols</DescriptorName><QualifierName UI="Q000009" MajorTopicYN="N">adverse effects</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D001132" MajorTopicYN="N">Arm</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D001365" MajorTopicYN="N">Axilla</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D001835" MajorTopicYN="N">Body Weight</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D001943" MajorTopicYN="N">Breast Neoplasms</DescriptorName><QualifierName UI="Q000473" MajorTopicYN="Y">pathology</QualifierName><QualifierName UI="Q000628" MajorTopicYN="Y">therapy</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D001952" MajorTopicYN="N">Bridged-Ring Compounds</DescriptorName><QualifierName UI="Q000008" MajorTopicYN="N">administration & dosage</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D005260" MajorTopicYN="N">Female</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D005500" MajorTopicYN="N">Follow-Up Studies</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D006801" MajorTopicYN="N">Humans</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D008197" MajorTopicYN="N">Lymph Node Excision</DescriptorName><QualifierName UI="Q000009" MajorTopicYN="Y">adverse effects</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D008207" MajorTopicYN="N">Lymphatic Metastasis</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D008209" MajorTopicYN="N">Lymphedema</DescriptorName><QualifierName UI="Q000175" MajorTopicYN="N">diagnosis</QualifierName><QualifierName UI="Q000209" MajorTopicYN="Y">etiology</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D008408" MajorTopicYN="N">Mastectomy</DescriptorName><QualifierName UI="Q000009" MajorTopicYN="N">adverse effects</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D008875" MajorTopicYN="N">Middle Aged</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D018962" MajorTopicYN="N">Phlebotomy</DescriptorName><QualifierName UI="Q000009" MajorTopicYN="N">adverse effects</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D011183" MajorTopicYN="N">Postoperative Complications</DescriptorName><QualifierName UI="Q000209" MajorTopicYN="N">etiology</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D011446" MajorTopicYN="N">Prospective Studies</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D011878" MajorTopicYN="N">Radiotherapy</DescriptorName><QualifierName UI="Q000009" MajorTopicYN="N">adverse effects</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D012307" MajorTopicYN="N">Risk Factors</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D043823" MajorTopicYN="N">Taxoids</DescriptorName><QualifierName UI="Q000008" MajorTopicYN="N">administration & dosage</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D013997" MajorTopicYN="N">Time Factors</DescriptorName></MeshHeading></MeshHeadingList><KeywordList Owner="NOTNLM"><Keyword MajorTopicYN="N">Air travel</Keyword><Keyword MajorTopicYN="N">Arm swelling</Keyword><Keyword MajorTopicYN="N">Axillary lymph node dissection</Keyword><Keyword MajorTopicYN="N">Blood pressure</Keyword><Keyword MajorTopicYN="N">Exercise</Keyword><Keyword MajorTopicYN="N">Needle punctures</Keyword></KeywordList></MedlineCitation><PubmedData><History><PubMedPubDate 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