Risk factors for lymphoedema in women with breast cancer: A large prospective cohort.
Identifieur interne : 000821 ( PubMed/Curation ); précédent : 000820; suivant : 000822Risk factors for lymphoedema in women with breast cancer: A large prospective cohort.
Auteurs : S L Kilbreath [Australie] ; K M Refshauge [Australie] ; J M Beith [Australie] ; L C Ward [Australie] ; O A Ung [Australie] ; E S Dylke [Australie] ; J R French [Australie] ; J. Yee [Australie] ; L. Koelmeyer [Australie] ; K. Gaitatzis [Australie]Source :
- Breast (Edinburgh, Scotland) [ 1532-3080 ] ; 2016.
Descripteurs français
- KwdFr :
- Adulte, Adulte d'âge moyen, Aisselle, Bras, Complications postopératoires (étiologie), Composés pontés (administration et posologie), Facteurs de risque, Facteurs temps, Femelle, Humains, Lymphadénectomie (effets indésirables), Lymphoedème (diagnostic), Lymphoedème (étiologie), Mastectomie (effets indésirables), Métastase lymphatique, Phlébotomie (effets indésirables), Poids du corps, Protocoles de polychimiothérapie antinéoplasique (effets indésirables), Radiothérapie (effets indésirables), Sujet âgé, Taxoïdes (administration et posologie), Tumeurs du sein (), Tumeurs du sein (anatomopathologie), Études de suivi, Études prospectives.
- MESH :
- administration et posologie : Composés pontés, Taxoïdes.
- anatomopathologie : Tumeurs du sein.
- diagnostic : Lymphoedème.
- effets indésirables : Lymphadénectomie, Mastectomie, Phlébotomie, Protocoles de polychimiothérapie antinéoplasique, Radiothérapie.
- étiologie : Complications postopératoires, Lymphoedème.
- Adulte, Adulte d'âge moyen, Aisselle, Bras, Facteurs de risque, Facteurs temps, Femelle, Humains, Métastase lymphatique, Poids du corps, Sujet âgé, Tumeurs du sein, Études de suivi, Études prospectives.
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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<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="KwdFr" xml:lang="fr"><term>Adulte</term>
<term>Adulte d'âge moyen</term>
<term>Aisselle</term>
<term>Bras</term>
<term>Complications postopératoires (étiologie)</term>
<term>Composés pontés (administration et posologie)</term>
<term>Facteurs de risque</term>
<term>Facteurs temps</term>
<term>Femelle</term>
<term>Humains</term>
<term>Lymphadénectomie (effets indésirables)</term>
<term>Lymphoedème (diagnostic)</term>
<term>Lymphoedème (étiologie)</term>
<term>Mastectomie (effets indésirables)</term>
<term>Métastase lymphatique</term>
<term>Phlébotomie (effets indésirables)</term>
<term>Poids du corps</term>
<term>Protocoles de polychimiothérapie antinéoplasique (effets indésirables)</term>
<term>Radiothérapie (effets indésirables)</term>
<term>Sujet âgé</term>
<term>Taxoïdes (administration et posologie)</term>
<term>Tumeurs du sein ()</term>
<term>Tumeurs du sein (anatomopathologie)</term>
<term>Études de suivi</term>
<term>Études prospectives</term>
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<keywords scheme="MESH" type="chemical" qualifier="administration & dosage" xml:lang="en"><term>Bridged-Ring Compounds</term>
<term>Taxoids</term>
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<term>Taxoïdes</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>
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<keywords scheme="MESH" qualifier="anatomopathologie" xml:lang="fr"><term>Tumeurs du sein</term>
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<keywords scheme="MESH" qualifier="diagnosis" xml:lang="en"><term>Lymphedema</term>
</keywords>
<keywords scheme="MESH" qualifier="diagnostic" xml:lang="fr"><term>Lymphoedème</term>
</keywords>
<keywords scheme="MESH" qualifier="effets indésirables" xml:lang="fr"><term>Lymphadénectomie</term>
<term>Mastectomie</term>
<term>Phlébotomie</term>
<term>Protocoles de polychimiothérapie antinéoplasique</term>
<term>Radiothérapie</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" qualifier="étiologie" xml:lang="fr"><term>Complications postopératoires</term>
<term>Lymphoedème</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>
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<term>Adulte d'âge moyen</term>
<term>Aisselle</term>
<term>Bras</term>
<term>Facteurs de risque</term>
<term>Facteurs temps</term>
<term>Femelle</term>
<term>Humains</term>
<term>Métastase lymphatique</term>
<term>Poids du corps</term>
<term>Sujet âgé</term>
<term>Tumeurs du sein</term>
<term>Études de suivi</term>
<term>Études prospectives</term>
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<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>
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<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>
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<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>
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<ForeName>K M</ForeName>
<Initials>KM</Initials>
<AffiliationInfo><Affiliation>Faculty of Health Sciences, University of Sydney, Sydney, Australia.</Affiliation>
</AffiliationInfo>
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<ForeName>J M</ForeName>
<Initials>JM</Initials>
<AffiliationInfo><Affiliation>Chris O'Brien Lifehouse, Camperdown, Australia.</Affiliation>
</AffiliationInfo>
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<Author ValidYN="Y"><LastName>Ward</LastName>
<ForeName>L C</ForeName>
<Initials>LC</Initials>
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</AffiliationInfo>
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<Author ValidYN="Y"><LastName>Ung</LastName>
<ForeName>O A</ForeName>
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<AffiliationInfo><Affiliation>Royal Brisbane and Women's Hospital, School of Medicine, The University of Queensland, Brisbane, Australia.</Affiliation>
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<Initials>ES</Initials>
<AffiliationInfo><Affiliation>Faculty of Health Sciences, University of Sydney, Sydney, Australia.</Affiliation>
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<Author ValidYN="Y"><LastName>French</LastName>
<ForeName>J R</ForeName>
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<AffiliationInfo><Affiliation>Faculty of Health Sciences, University of Sydney, Sydney, Australia.</Affiliation>
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<Author ValidYN="Y"><LastName>Koelmeyer</LastName>
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<Initials>L</Initials>
<AffiliationInfo><Affiliation>Westmead Breast Cancer Institute, Westmead Hospital, Westmead, Australia.</Affiliation>
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<Initials>K</Initials>
<AffiliationInfo><Affiliation>Faculty of Health Sciences, University of Sydney, Sydney, Australia.</Affiliation>
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<ArticleDate DateType="Electronic"><Year>2016</Year>
<Month>05</Month>
<Day>13</Day>
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<MedlineJournalInfo><Country>Netherlands</Country>
<MedlineTA>Breast</MedlineTA>
<NlmUniqueID>9213011</NlmUniqueID>
<ISSNLinking>0960-9776</ISSNLinking>
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<ChemicalList><Chemical><RegistryNumber>0</RegistryNumber>
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<Chemical><RegistryNumber>0</RegistryNumber>
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<MeshHeading><DescriptorName UI="D005500" MajorTopicYN="N">Follow-Up Studies</DescriptorName>
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<QualifierName UI="Q000209" MajorTopicYN="Y">etiology</QualifierName>
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<MeshHeading><DescriptorName UI="D008875" MajorTopicYN="N">Middle Aged</DescriptorName>
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<MeshHeading><DescriptorName UI="D018962" MajorTopicYN="N">Phlebotomy</DescriptorName>
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<MeshHeading><DescriptorName UI="D011446" MajorTopicYN="N">Prospective Studies</DescriptorName>
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<MeshHeading><DescriptorName UI="D011878" MajorTopicYN="N">Radiotherapy</DescriptorName>
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<MeshHeading><DescriptorName UI="D012307" MajorTopicYN="N">Risk Factors</DescriptorName>
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<MeshHeading><DescriptorName UI="D013997" MajorTopicYN="N">Time Factors</DescriptorName>
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</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>
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<PubmedData><History><PubMedPubDate PubStatus="received"><Year>2015</Year>
<Month>12</Month>
<Day>19</Day>
</PubMedPubDate>
<PubMedPubDate PubStatus="revised"><Year>2016</Year>
<Month>04</Month>
<Day>18</Day>
</PubMedPubDate>
<PubMedPubDate PubStatus="accepted"><Year>2016</Year>
<Month>04</Month>
<Day>24</Day>
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<PubMedPubDate PubStatus="entrez"><Year>2016</Year>
<Month>5</Month>
<Day>17</Day>
<Hour>6</Hour>
<Minute>0</Minute>
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<PubMedPubDate PubStatus="pubmed"><Year>2016</Year>
<Month>5</Month>
<Day>18</Day>
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<PubMedPubDate PubStatus="medline"><Year>2017</Year>
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<ArticleIdList><ArticleId IdType="pubmed">27183497</ArticleId>
<ArticleId IdType="pii">S0960-9776(16)30041-8</ArticleId>
<ArticleId IdType="doi">10.1016/j.breast.2016.04.011</ArticleId>
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