title: Systemic analysis on risk factors for breast cancer related lymphedema.
abstract: BACKGROUND
  To evaluate risk factors for upper extremity lymphedema due to breast cancer surgery.
  
  
  METHODS
  Clinical studies published on PubMed, Ovid, EMbase, and Cochrane Library from January 1996 to December 2012 were selected.
  
  
  RESULTS
  Twenty-five studies were identified, including 12,104 patients. Six risk factors related to the incidence of lymphedema after breast cancer treatment were detected: axillary lymph node dissection (OR=3.73, 95%CI 1.16 to 11.96), postoperative complications (OR=2.64, 95%CI 1.10 to 6.30), hypertension (OR=1.83, 95%CI 1.38 to 2.42), high body mass index (OR=1.80, 95%CI 1.30 to 2.49), chemotherapy (OR=1.38, 95%CI 1.07 to 1.79) and radiotherapy (OR=1.35, 95%CI 1.10 to 1.66). We found significant protective factors for lymphedema: pathologic T classification (OR=0.57, 95%CI 0.36 to 0.91) and stage (OR=0.60, 95%CI 0.39 to 0.93), while some factors, like age, number of positive lymph nodes, number of lymph node dissection, demonstrated no obvious correlation.
  
  
  CONCLUSIONS
  Axillary lymph node dissection, postoperative complications, hypertension, body mass index, chemotherapy, radiotherapy are risk factors for lymphedema after breast cancer treatment. Attention should be paid to patients with risk factors to prevent the occurrence of lymphedema.
authors.affiliation: Department of Radiotherapy and Oncology, The Second Affiliated Hospital of Soochow University, Suzhou, China * E-mail : dryetiandryetian001@hotmail.com.
authors.forename: Ya-Qun
authors.initials: YQ
authors.lastname: Zhu
authors.forename: Yu-Huan
authors.initials: YH
authors.lastname: Xie
authors.forename: Feng-Huan
authors.initials: FH
authors.lastname: Liu
authors.forename: Qi
authors.initials: Q
authors.lastname: Guo
authors.forename: Pei-Pei
authors.initials: PP
authors.lastname: Shen
authors.forename: Ye
authors.initials: Y
authors.lastname: Tian
mesh_terms: D001365:Axilla / Q000601:surgery; D015992:Body Mass Index; D001943:Breast Neoplasms / Q000209:etiology* / Q000473:pathology* / Q000628:therapy; D005260:Female; D006801:Humans; D006973:Hypertension; D008197:Lymph Node Excision; D008209:Lymphedema / Q000150:complications*; D011183:Postoperative Complications; D012307:Risk Factors; D013602:T-Lymphocytes, Cytotoxic / Q000276:immunology; D034941:Upper Extremity / Q000473:pathology*