Risk factors for lymphoedema in women with breast cancer: a large prospective cohort

Kilbreath, S. L., Refshauge, K. M., Beith, J. M., Ward, L. C., Ung, O. A., Dylke, E. S., French, J. R., Yee, J., Koelmeyer, L. and Gaitatzis, K. (2016) Risk factors for lymphoedema in women with breast cancer: a large prospective cohort. The Breast, 28 29-36. doi:10.1016/j.breast.2016.04.011


Author Kilbreath, S. L.
Refshauge, K. M.
Beith, J. M.
Ward, L. C.
Ung, O. A.
Dylke, E. S.
French, J. R.
Yee, J.
Koelmeyer, L.
Gaitatzis, K.
Title Risk factors for lymphoedema in women with breast cancer: a large prospective cohort
Journal name The Breast   Check publisher's open access policy
ISSN 0960-9776
1532-3080
Publication date 2016-08-01
Sub-type Article (original research)
DOI 10.1016/j.breast.2016.04.011
Open Access Status Not Open Access
Volume 28
Start page 29
End page 36
Total pages 8
Place of publication London, United Kingdom
Publisher Churchill Livingstone
Collection year 2017
Language eng
Formatted 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.
Keyword Air travel
Arm swelling
Axillary lymph node dissection
Blood pressure
Exercise
Needle punctures
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Article (original research)
Collections: HERDC Pre-Audit
School of Chemistry and Molecular Biosciences
 
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Created: Fri, 20 May 2016, 23:43:05 EST by Mrs Louise Nimwegen on behalf of School of Chemistry & Molecular Biosciences