Case-control study to evaluate predictors of lymphedema after breast cancer surgery.
OBJECTIVE
To identify risk factors for lymphedema after breast cancer surgery.


METHODS
Multisite case-control study.


METHODS
Lymphedema clinics in the upper midwestern region of the United States.


METHODS
94 patients with lymphedema and 94 controls without lymphedema, matched on type of axillary surgery and surgery date.


METHODS
The Measure of Arm Symptom Survey, a patient-completed tool, assessed potential risk factors for lymphedema. Severity of lymphedema was measured by arm circumference, and disease and treatment factors were collected via chart review.


METHODS
Risk factors for lymphedema after breast cancer surgery.


RESULTS
On univariate analysis, patients with lymphedema were more likely than controls to be overweight (body mass index >or= 25) (p = 0.009). They also were more likely to have had axillary radiation (p = 0.011), mastectomy (p = 0.008), chemotherapy (p = 0.033), more positive nodes (p = 0.009), fluid aspirations after surgery (p = 0.005), and active cancer status (p = 0.008). Strength training (p = 0.014) and air travel (p = 0.0005) were associated with less lymphedema occurrence. On multivariate analysis, the only factor significantly associated with lymphedema was being overweight (p = 0.022).


CONCLUSIONS
Being overweight is an important modifiable risk factor for lymphedema. Axillary radiation, more extensive surgery, chemotherapy, and active cancer status also were predictive of lymphedema.


CONCLUSIONS
This study provides evidence that excess weight contributes to lymphedema; strength training and airline travel did not contribute to lymphedema.
Swenson
Karen K
KK
Park Nicollet Institute. karen.swenson@parknicollet.com
Nissen
Mary Jo
MJ
Leach
Joseph W
JW
Post-White
Janice
J
D000203:Activities of Daily Living / Q000523:psychology; D000704:Analysis of Variance; D000886:Anthropometry; D001294:Attitude to Health; D001943:Breast Neoplasms / Q000150:complications / Q000601:surgery*; D016022:Case-Control Studies; D006801:Humans; D015994:Incidence; D008197:Lymph Node Excision / Q000009:adverse effects* / Q000379:methods; D008209:Lymphedema / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology* / Q000523:psychology*; D008408:Mastectomy / Q000009:adverse effects / Q000379:methods; D015146:Midwestern United States / Q000453:epidemiology; D008910:Minnesota / Q000453:epidemiology; D009730:Nursing Assessment; D015404:Nursing Methodology Research; D009765:Obesity / Q000150:complications; D015995:Prevalence; D018570:Risk Assessment; D012307:Risk Factors; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires