Treatment-related risk factors for arm lymphedema among long-term breast cancer survivors.
BACKGROUND
Treatment-related factors may increase the risk for arm lymphedema, which may occur after surgery or even many years after initial treatment for breast cancer. The association between treatment-related risk factors and development of arm lymphedema was examined for women who participated in the long-term quality of life (LTQOL) study, a 12-15-year follow-up of a breast cancer case-control study of Hispanic and non-Hispanic white women.


METHODS
Among 199 cases, 43 women (15 Hispanic, 28 non-Hispanic white) reported physician-diagnosed lymphedema during follow-up. Multivariable logistic regression analysis was used to calculate the odds ratios (OR) and 95% confidence intervals (CI) for the association of risk factors with lymphedema, adjusting for relevant covariates.


RESULTS
Tamoxifen had a non-significant, positive association with lymphedema (OR = 2.07, 95% CI 0.94-4.55, p =0.07). There were no significant associations with type of surgery, radiation, or chemotherapy. Risk was increased specifically in overweight and obese women (body mass index (BMI) > =25 kg/m(2)) treated with tamoxifen (OR = 2.62, 95% CI 0.99-6.93, p = 0.05).


CONCLUSIONS
This study suggests that breast cancer survivors with a BMI >25 who report the use of tamoxifen therapy may be at increased risk for arm lymphedema.


CONCLUSIONS
Larger case-control studies and clinical trials should investigate the long-term association of tamoxifen treatment with arm lymphedema especially in overweight and obese women. Lymphedema risk may be another indication to consider a weight reduction program in breast cancer survivors.
Department of Epidemiology and Population Health, University of Louisville, Louisville, KY, 40202, USA.
Nandita
N
Das
Richard N
RN
Baumgartner
Elizabeth C
EC
Riley
Christina M
CM
Pinkston
Dongyan
D
Yang
Kathy B
KB
Baumgartner
D001132:Arm / Q000473:pathology*; D001943:Breast Neoplasms / Q000150:complications* / Q000401:mortality; D005260:Female; D006801:Humans; D008209:Lymphedema / Q000209:etiology*; D008875:Middle Aged; D011788:Quality of Life; D012307:Risk Factors; D017741:Survivors; D016896:Treatment Outcome