Influence of body mass index on the frequency of lymphedema and other complications after surgery for breast cancer
DOI:
https://doi.org/10.1590/1809-2950/14743623012016Abstract
Objective: this study assessed the influence of pre-operative body mass index (BMI) has upon lymphedema, scar tissue adhesion, pain, and heaviness in the upper limb at two years after surgery for breast cancer. Methods: retrospective analysis of 631 medical records of women who underwent surgery for breast cancer and were referred to the Physiotherapy Program at Prof. Dr. José Aristodemo Pinotti Women's Hospital of the Center for Integral Women's Health Care, CAISM/UNICAMP between January 2006 and December 2007. Results: mean age of women was 56.5 years (±13.7 years) and the most part (55%) were overweight or obese, surgical stages II and III were present in 63% of women studied. Radical mastectomy was the most frequent surgery (54.4%), followed by quadrantectomy (32.1%). In the first year after surgery, there was no significant association between BMI categories and incidence of scar tissue adhesion, pain, heaviness and lymphedema. In the second year, overweight and obese women had higher rates of heaviness in the upper limb and lymphedema. For lymphedema, there was a significant difference among BMI categories (p=0.0268). Obese women are 3.6 times more likely to develop lymphedema in the second year after surgery (odds ratio 3.61 95% CI 1.36 to 9.41). Conclusion: BMI ≥25kg/m2 prior to treatment for breast cancer can be considered a risk factor for developing lymphedema in the two years after surgery. There was no association between BMI and the development of other complications.Downloads
References
Chan DN, Lui LY, So WK. Effectiveness of exercise programmes
on shoulder mobility and lymphoedema after axillary lymph
node dissection for breast cancer: systematic review. J Adv
Nurs. 2010; 66(9): 1902-14.
Mols F, Vingerhoets AJ, Coebergh JW, van de Poll-Franse LV.
Quality of life among long-term breast cancer survivors: a
systematic review. Eur J Cancer. 2005; 41(17): 613-9.
Hack TF, Kwan WB, Thomas-MacLean RL, Towers A, Miedema
B, Tilley A, et al. Predictors of arm morbidity following breast
cancer surgery. Psycho-Oncol. 2010; 19: 1205-12.
Devoogdt N, Van Kampen M, Christiaens MR, Troosters T, Piot
W, Beets N, et al. Short. – and long-term recovery of upper
limb function after axillary lymph node dissection. Eur J
Cancer Care. 2011; 20: 77-86.
Kwan ML, Darbinian J, Schmitz KH, Citron R, Partee P, Kutner
SE, Kushi LH. Risk factors for lymphedema in a prospective
breast cancer survivorship study: the pathways study. Arch
Surg. 2010; 145(11):1055-63.
Ahmed RL, Schmitz KH, Prizment AE, Folsom AR. Risk
factors for lymphedema in breast cancer survivors, the Iowa
Women’s Health Study. Breast Cancer Res Treat. 2011; 130(3):
-91.
Helyer LK, Varnic M, Le LW, Leong W, McCready D. Obesity
is a risk factor for developing postoperative lymphedema in
breast cancer patients. Breast J. 2010; 16(1): 48-54.
Ridner SH, Dietrich MS, Stewart BR, Armer JM. Body mass
index and breast cancer treatment-related lymphedema.
Support Care Cancer. 2011; 19: 853-7.
Savetsky IL, Torrisi JS, Cuzzone DA, Ghanta S, Albano NJ,
Gardenier JC, Joseph WJ, Mehrara BJ. Obesity increases inflammation and impairs lymphatic function in a mouse
model of lymphedema. Am J Physiol Heart Circ Physiol. 2014;
; 307(2).
World Health Organization (WHO). Obesity and overweight.
Fact sheet Nº 311. 2006. Available in: http://www.who.int/
mediacentre/factsheets/fs311/en/index.html. Accessed in:
th, February, 2015.
Asim M, Cham A, Banerjee S, Nancekivell R, Dutu G, McBride
C, Cavanagh S, Lawrenson R, Campbell I. Difficulties with
defining lymphoedema after axillary dissection for breast
cancer. N Z Med J. 2012; 125(1351): 29-39.
Oliveira MM, Gurgel MS, Miranda MS, Okubo MA, Feijó LF,
Souza GA. Efficacy of shoulder exercises on locoregional
complications in women undergoing radiotherapy for breast
cancer: clinical trial. Rev Bras Fisioter. 2009; 13: 136-43
Lee TS, Kilbreath SL, Refshauge KM, Herbert RD, Beith JM.
Prognosis of the upper limb following surgery and radiation
for breast cancer. Breast Cancer Res Treat. 2008; 110(1): 19-37.
Meeske KA, Sullivan-Halley J, Smith AW, McTiernan A,
Baumgartner KB, Harlan LC, et al. Risk factors for arm
lymphedema following breast cancer diagnosis in black
women and white women. Breast Cancer Res Treat. 2009;
(2): 383-91.
Paskett ED, Naughton MJ, McCoy TP, Case LD, Abbott JM. The
epidemiology of arm and hand swelling in premenopausal
breast cancer survivors. Cancer Epidemiol Biomarkers Prev.
; 16 (4): 775-82.
Koul R, Dufan T, Russell C, Guenther W, Nugent Z, Sun X,
et al. Efficacy of complete decongestive therapy and
manual lymphatic drainage on treatment-related
lymphedema in breast cancer. Int J Radiat Oncol Biol
Phys. 2007; 1; 67(3):841-6.
Nesvold IL, Dahl AA, Løkkevik E, Mengshoel AM, Fossa
SD. Arm and shoulder morbidity in breast cancer patients
after breast-conserving therapy versus mastectomy. Acta
Oncologic. 2008; 47: 835-42.
Soran A, D’Angelo G, Begovic M, Ardic F, Harlak A, Samuel
Wieand H, et al. Breast cancer-related lymphedema: what are
the significant predictors and how they affect the severity of
lymphedema? Breast J. 2006; 12(6): 536-43.
Stanton A, Holroyd B, Mortimer P, Levick J. Comparison of
microvascular filtration in human arms with and without
postmastectomy oedema. Exp Physiol. 1999; 84: 405-19.
Mak SS, Yeo W, Lee YM, Mo KF, Tse KY, Tse SM, et al. Predictors
of lymphedema in patients with breast cancer undergoing
axillary lymph node dissection in Hong Kong. Nurs Res.
; 57(6): 416-25.
Hayes SC, Janda M, Cornish B, Battistutta D, Newman B.
Lymphedema after breast cancer: incidence, risk factors, and
effect on upper body function. J Clin Oncol. 2008; 26(21):
-42.
Lane K, Worsley D, Mckenzie D. Exercise and the lymphatic
system. – implications for breast-cancer survivors. Sport
Med. 2005; 35(6): 461-71.
Bicego D, Brown K, Ruddick M, Storey D, Wong C, Harris SR.
Exercise for women with or at risk for breast cancer-related
lymphedema. Phys Ther. 2006; 86(10): 1398-405.
Schmitz KH, Ahmed RL, Troxel A, Cheville A, Smith R, LewisGrant L, et al. Weight lifting in women with breast cancerrelated lymphedema. N Engl J Med. 2009; 361(7): 664-73
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