Database study of risk factors for breast cancer-related lymphedema: statistical analysis of 2359 cases in 10 years

Author:

Matsumoto Akihiro1ORCID,Ushio Kai1,Kimura Hiroaki1,Tomioka Shinichi2,Sasada Shinsuke3,Mikami Yukio4

Affiliation:

1. Department of Rehabilitation Medicine, Hiroshima University Hospital

2. Department of Public Health and Health Policy, Hiroshima University

3. Department of Breast Surgery, Hiroshima University Hospital

4. Department of Rehabilitation Medicine, Wakayama Medical University

Abstract

Abstract Background Identification of risk factors is important for the prevention of Breast Cancer-Related Lymphedema (BCRL), and epidemiological large-scale studies are needed. Although database studies are suitable for large-scale surveys, there have been no studies using databases to investigate risk factors for BCRL. The purpose of this study was to test the hypothesis that database-based studies are useful in identifying risk factors for BCRL. Methods Patients diagnosed with breast cancer during a 10-year period from April 2009 to March 2020 were selected from the medical database of Hiroshima University Hospital. As a retrospective observational study, risk factors for BCRL were validated by logistic regression analysis (p < 0.05). Results A total of 4471 breast cancer patients were selected and 2359 met study criteria; the incidence of BCRL was 4.8%. Risk factors for BCRL ultimately identified by multivariate logistic regression analysis were obesity with BMI 25 to 30 (OR = 3.066, 95%CI: 1.408 ~ 6.677), severe obesity with BMI > 30 (OR = 5.791, 95%CI: 2.239 ~ 14.97), surgical axillary lymph node dissection (OR = 3.212, 95%CI: 1 .918 ~ 5.378), chemotherapy with docetaxel (OR = 1.795, 95%CI: 1.062 ~ 3.032), and conventional radiation to the breast or chest wall with lymph nodes in the irradiated area (OR = 3.299, 95%CI: 1.842 ~ 5.910). Conclusions The risk factors for BCRL identified in this study were generally similar to those in previous studies, indicating that database-based studies are useful for identifying risk factors for BCRL. A multicenter study involving a larger number of patients and study items needs to be conducted in order to more fully elucidate the risk factors for BCRL.

Publisher

Research Square Platform LLC

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