Impact of body mass index and weight fluctuation on lymphedema risk in patients treated for breast cancer.
Identifieur interne : 001889 ( PubMed/Curation ); précédent : 001888; suivant : 001890Impact of body mass index and weight fluctuation on lymphedema risk in patients treated for breast cancer.
Auteurs : Lauren S. Jammallo ; Cynthia L. Miller ; Marybeth Singer ; Nora K. Horick ; Melissa N. Skolny ; Michelle C. Specht ; Jean O'Toole ; Alphonse G. TaghianSource :
- Breast cancer research and treatment [ 1573-7217 ] ; 2013.
Descripteurs français
- KwdFr :
- MESH :
- épidémiologie : Lymphoedème.
- étiologie : Lymphoedème.
- Adulte, Adulte d'âge moyen, Femelle, Humains, Indice de masse corporelle, Poids du corps, Période postopératoire, Période préopératoire, Risque, Sujet âgé, Sujet âgé de 80 ans ou plus, Tumeurs du sein, Études de suivi.
English descriptors
- KwdEn :
- MESH :
- complications : Breast Neoplasms.
- epidemiology : Lymphedema.
- etiology : Lymphedema.
- surgery : Breast Neoplasms.
- Adult, Aged, Aged, 80 and over, Body Mass Index, Body Weight, Female, Follow-Up Studies, Humans, Middle Aged, Postoperative Period, Preoperative Period, Risk.
Abstract
Identifying risk factors for lymphedema in patients treated for breast cancer has become increasingly important, given the current lack of standardization surrounding diagnosis and treatment. Reports on the association of body mass index (BMI) and weight change with lymphedema risk are conflicting. We sought to examine the impact of pre-operative BMI and post-treatment weight change on the incidence of lymphedema. From 2005 to 2011, 787 newly diagnosed breast cancer patients underwent prospective arm volume measurements with a Perometer pre- and post-operatively. BMI was calculated from same-day weight and height measurements. Lymphedema was defined as a relative volume change (RVC) of ≥ 10 %. Univariate and multivariate Cox proportional hazards models were used to evaluate the association between lymphedema risk and pre-operative BMI, weight change, and other demographic and treatment factors. By multivariate analysis, a pre-operative BMI ≥ 30 was significantly associated with an increased risk of lymphedema compared to a pre-operative BMI <25 and 25- <30 (p = 0.001 and p = 0.012, respectively). Patients with a pre-operative BMI 25- <30 were not at an increased risk of lymphedema compared to patients with a pre-operative BMI <25 (p = 0.409). Furthermore, a cumulative absolute weight fluctuation of 10 pounds gained/lost per month post-operatively significantly increased risk of lymphedema (HR: 1.97, p = < 0.0001). In conclusion, pre-operative BMI of ≥ 30 is an independent risk factor for lymphedema, whereas a BMI of 25- <30 is not. Large post-operative weight fluctuations also increase risk of lymphedema. Patients with a pre-operative BMI ≥ 30 and those who experience large weight fluctuations during and after treatment for breast cancer should be considered at higher-risk for lymphedema. Close monitoring or early intervention to ensure optimal treatment of the condition may be appropriate for these patients.
DOI: 10.1007/s10549-013-2715-7
PubMed: 24122390
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pubmed:24122390Le document en format XML
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Jammallo</name></author><author><name sortKey="Miller, Cynthia L" sort="Miller, Cynthia L" uniqKey="Miller C" first="Cynthia L" last="Miller">Cynthia L. Miller</name></author><author><name sortKey="Singer, Marybeth" sort="Singer, Marybeth" uniqKey="Singer M" first="Marybeth" last="Singer">Marybeth Singer</name></author><author><name sortKey="Horick, Nora K" sort="Horick, Nora K" uniqKey="Horick N" first="Nora K" last="Horick">Nora K. Horick</name></author><author><name sortKey="Skolny, Melissa N" sort="Skolny, Melissa N" uniqKey="Skolny M" first="Melissa N" last="Skolny">Melissa N. Skolny</name></author><author><name sortKey="Specht, Michelle C" sort="Specht, Michelle C" uniqKey="Specht M" first="Michelle C" last="Specht">Michelle C. 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Taghian</name></author></analytic><series><title level="j">Breast cancer research and treatment</title><idno type="eISSN">1573-7217</idno><imprint><date when="2013" type="published">2013</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Adult</term><term>Aged</term><term>Aged, 80 and over</term><term>Body Mass Index</term><term>Body Weight</term><term>Breast Neoplasms (complications)</term><term>Breast Neoplasms (surgery)</term><term>Female</term><term>Follow-Up Studies</term><term>Humans</term><term>Lymphedema (epidemiology)</term><term>Lymphedema (etiology)</term><term>Middle Aged</term><term>Postoperative Period</term><term>Preoperative Period</term><term>Risk</term></keywords><keywords scheme="KwdFr" xml:lang="fr"><term>Adulte</term><term>Adulte d'âge moyen</term><term>Femelle</term><term>Humains</term><term>Indice de masse corporelle</term><term>Lymphoedème (épidémiologie)</term><term>Lymphoedème (étiologie)</term><term>Poids du corps</term><term>Période postopératoire</term><term>Période préopératoire</term><term>Risque</term><term>Sujet âgé</term><term>Sujet âgé de 80 ans ou plus</term><term>Tumeurs du sein ()</term><term>Études de suivi</term></keywords><keywords scheme="MESH" qualifier="complications" xml:lang="en"><term>Breast Neoplasms</term></keywords><keywords scheme="MESH" qualifier="epidemiology" xml:lang="en"><term>Lymphedema</term></keywords><keywords scheme="MESH" qualifier="etiology" xml:lang="en"><term>Lymphedema</term></keywords><keywords scheme="MESH" qualifier="surgery" xml:lang="en"><term>Breast Neoplasms</term></keywords><keywords scheme="MESH" qualifier="épidémiologie" xml:lang="fr"><term>Lymphoedème</term></keywords><keywords scheme="MESH" qualifier="étiologie" xml:lang="fr"><term>Lymphoedème</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Adult</term><term>Aged</term><term>Aged, 80 and over</term><term>Body Mass Index</term><term>Body Weight</term><term>Female</term><term>Follow-Up Studies</term><term>Humans</term><term>Middle Aged</term><term>Postoperative Period</term><term>Preoperative Period</term><term>Risk</term></keywords><keywords scheme="MESH" xml:lang="fr"><term>Adulte</term><term>Adulte d'âge moyen</term><term>Femelle</term><term>Humains</term><term>Indice de masse corporelle</term><term>Poids du corps</term><term>Période postopératoire</term><term>Période préopératoire</term><term>Risque</term><term>Sujet âgé</term><term>Sujet âgé de 80 ans ou plus</term><term>Tumeurs du sein</term><term>Études de suivi</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">Identifying risk factors for lymphedema in patients treated for breast cancer has become increasingly important, given the current lack of standardization surrounding diagnosis and treatment. Reports on the association of body mass index (BMI) and weight change with lymphedema risk are conflicting. We sought to examine the impact of pre-operative BMI and post-treatment weight change on the incidence of lymphedema. From 2005 to 2011, 787 newly diagnosed breast cancer patients underwent prospective arm volume measurements with a Perometer pre- and post-operatively. BMI was calculated from same-day weight and height measurements. Lymphedema was defined as a relative volume change (RVC) of ≥ 10 %. Univariate and multivariate Cox proportional hazards models were used to evaluate the association between lymphedema risk and pre-operative BMI, weight change, and other demographic and treatment factors. By multivariate analysis, a pre-operative BMI ≥ 30 was significantly associated with an increased risk of lymphedema compared to a pre-operative BMI <25 and 25- <30 (p = 0.001 and p = 0.012, respectively). Patients with a pre-operative BMI 25- <30 were not at an increased risk of lymphedema compared to patients with a pre-operative BMI <25 (p = 0.409). Furthermore, a cumulative absolute weight fluctuation of 10 pounds gained/lost per month post-operatively significantly increased risk of lymphedema (HR: 1.97, p = < 0.0001). In conclusion, pre-operative BMI of ≥ 30 is an independent risk factor for lymphedema, whereas a BMI of 25- <30 is not. Large post-operative weight fluctuations also increase risk of lymphedema. Patients with a pre-operative BMI ≥ 30 and those who experience large weight fluctuations during and after treatment for breast cancer should be considered at higher-risk for lymphedema. Close monitoring or early intervention to ensure optimal treatment of the condition may be appropriate for these patients.</div></front></TEI><pubmed><MedlineCitation Status="MEDLINE" Owner="NLM"><PMID Version="1">24122390</PMID><DateCreated><Year>2013</Year><Month>12</Month><Day>17</Day></DateCreated><DateCompleted><Year>2014</Year><Month>06</Month><Day>09</Day></DateCompleted><DateRevised><Year>2016</Year><Month>10</Month><Day>19</Day></DateRevised><Article PubModel="Print"><Journal><ISSN IssnType="Electronic">1573-7217</ISSN><JournalIssue CitedMedium="Internet"><Volume>142</Volume><Issue>1</Issue><PubDate><Year>2013</Year><Month>Nov</Month></PubDate></JournalIssue><Title>Breast cancer research and treatment</Title><ISOAbbreviation>Breast Cancer Res. Treat.</ISOAbbreviation></Journal><ArticleTitle>Impact of body mass index and weight fluctuation on lymphedema risk in patients treated for breast cancer.</ArticleTitle><Pagination><MedlinePgn>59-67</MedlinePgn></Pagination><Abstract><AbstractText>Identifying risk factors for lymphedema in patients treated for breast cancer has become increasingly important, given the current lack of standardization surrounding diagnosis and treatment. Reports on the association of body mass index (BMI) and weight change with lymphedema risk are conflicting. We sought to examine the impact of pre-operative BMI and post-treatment weight change on the incidence of lymphedema. From 2005 to 2011, 787 newly diagnosed breast cancer patients underwent prospective arm volume measurements with a Perometer pre- and post-operatively. BMI was calculated from same-day weight and height measurements. Lymphedema was defined as a relative volume change (RVC) of ≥ 10 %. Univariate and multivariate Cox proportional hazards models were used to evaluate the association between lymphedema risk and pre-operative BMI, weight change, and other demographic and treatment factors. By multivariate analysis, a pre-operative BMI ≥ 30 was significantly associated with an increased risk of lymphedema compared to a pre-operative BMI <25 and 25- <30 (p = 0.001 and p = 0.012, respectively). Patients with a pre-operative BMI 25- <30 were not at an increased risk of lymphedema compared to patients with a pre-operative BMI <25 (p = 0.409). Furthermore, a cumulative absolute weight fluctuation of 10 pounds gained/lost per month post-operatively significantly increased risk of lymphedema (HR: 1.97, p = < 0.0001). In conclusion, pre-operative BMI of ≥ 30 is an independent risk factor for lymphedema, whereas a BMI of 25- <30 is not. Large post-operative weight fluctuations also increase risk of lymphedema. Patients with a pre-operative BMI ≥ 30 and those who experience large weight fluctuations during and after treatment for breast cancer should be considered at higher-risk for lymphedema. Close monitoring or early intervention to ensure optimal treatment of the condition may be appropriate for these patients.</AbstractText></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Jammallo</LastName><ForeName>Lauren S</ForeName><Initials>LS</Initials></Author><Author ValidYN="Y"><LastName>Miller</LastName><ForeName>Cynthia L</ForeName><Initials>CL</Initials></Author><Author ValidYN="Y"><LastName>Singer</LastName><ForeName>Marybeth</ForeName><Initials>M</Initials></Author><Author ValidYN="Y"><LastName>Horick</LastName><ForeName>Nora K</ForeName><Initials>NK</Initials></Author><Author ValidYN="Y"><LastName>Skolny</LastName><ForeName>Melissa N</ForeName><Initials>MN</Initials></Author><Author ValidYN="Y"><LastName>Specht</LastName><ForeName>Michelle C</ForeName><Initials>MC</Initials></Author><Author ValidYN="Y"><LastName>O'Toole</LastName><ForeName>Jean</ForeName><Initials>J</Initials></Author><Author ValidYN="Y"><LastName>Taghian</LastName><ForeName>Alphonse G</ForeName><Initials>AG</Initials></Author></AuthorList><Language>eng</Language><GrantList CompleteYN="Y"><Grant><GrantID>P50 CA089393</GrantID><Acronym>CA</Acronym><Agency>NCI NIH HHS</Agency><Country>United States</Country></Grant><Grant><GrantID>R01 CA139118</GrantID><Acronym>CA</Acronym><Agency>NCI NIH HHS</Agency><Country>United States</Country></Grant><Grant><GrantID>P50CA089393</GrantID><Acronym>CA</Acronym><Agency>NCI NIH HHS</Agency><Country>United States</Country></Grant><Grant><GrantID>R01CA139118</GrantID><Acronym>CA</Acronym><Agency>NCI NIH HHS</Agency><Country>United States</Country></Grant></GrantList><PublicationTypeList><PublicationType UI="D016428">Journal Article</PublicationType><PublicationType UI="D052061">Research Support, N.I.H., Extramural</PublicationType></PublicationTypeList></Article><MedlineJournalInfo><Country>Netherlands</Country><MedlineTA>Breast Cancer Res 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Version="1">21079093</PMID></CommentsCorrections></CommentsCorrectionsList><MeshHeadingList><MeshHeading><DescriptorName UI="D000328" MajorTopicYN="N">Adult</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D000368" MajorTopicYN="N">Aged</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D000369" MajorTopicYN="N">Aged, 80 and over</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D015992" MajorTopicYN="Y">Body Mass Index</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D001835" MajorTopicYN="Y">Body Weight</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D001943" MajorTopicYN="N">Breast Neoplasms</DescriptorName><QualifierName UI="Q000150" MajorTopicYN="Y">complications</QualifierName><QualifierName UI="Q000601" MajorTopicYN="N">surgery</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="D008209" MajorTopicYN="N">Lymphedema</DescriptorName><QualifierName UI="Q000453" MajorTopicYN="N">epidemiology</QualifierName><QualifierName UI="Q000209" MajorTopicYN="Y">etiology</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D008875" MajorTopicYN="N">Middle Aged</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D011184" MajorTopicYN="N">Postoperative Period</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D057234" MajorTopicYN="N">Preoperative Period</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D012306" MajorTopicYN="N">Risk</DescriptorName></MeshHeading></MeshHeadingList><OtherID Source="NLM">NIHMS531443</OtherID><OtherID Source="NLM">PMC3873728</OtherID></MedlineCitation><PubmedData><History><PubMedPubDate 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