Risk Factors for Lymphedema in Patients Treated for Breast Cancer
In a study reported in the Journal of Clinical Oncology, Ferguson et al found that cellulitis in the affected arm, but not blood draws, injections, trauma to the affected arm, or air travel, was associated with an increased risk of lymphedema in women treated for breast cancer.
Study Details
In the study, patients undergoing treatment for breast cancer between 2005 and 2014 were prospectively screened for lymphedema. Bilateral arm volume measurements were performed preoperatively and postoperatively, with patients reporting at each measurement the number of blood draws, injections, blood pressure measurements, trauma to at-risk arm(s), and number of flights taken since the last measurement.
Associations With Lymphedema
Among a total of 3,041 measurements, including 2,849 with lymphedema, there was no significant association between relative arm volume change or weight-adjusted change increase and undergoing at least one blood draw (P = .62), injections (P = .77), trauma (P = .0811), number of flights (P = .77 for one or two and P = .91 for three or four vs none), or duration of flights (P = .43 for 1–12 hours and P = .54 for ≥ 12 hours vs none) on univariate analysis. Body mass index ≥ 25 lb/in2 at diagnosis (P = .0064), axillary lymph node dissection (P = .0003), having blood pressure readings (P = .034), regional lymph node irradiation (P < .001), and cellulitis (P < .001) were significantly associated with arm volume increases.
On multivariate analysis, body mass index ≥ 25 lb/in2 (P = .0236, axillary lymph node dissection (P < .001), regional lymph node irradiation (P = .0364), and cellulitis (P < .001) were associated with increases in arm volume.
The investigators concluded: “This study suggests that although cellulitis increases risk of lymphedema, ipsilateral blood draws, injections, blood pressure readings, and air travel may not be associated with arm volume increases. The results may help to educate clinicians and patients on post-treatment risk, prevention, and management of lymphedema.”
The study was supported by the National Cancer Institute and the Adele McKinnon Research Fund for Breast Cancer-Related Lymphedema.
Alphonse G. Taghian, MD, PhD, of Massachusetts General Hospital, is the corresponding author of the Journal of Clinical Oncology article.
The content in this post has not been reviewed by the American Society of Clinical Oncology, Inc. (ASCO®) and does not necessarily reflect the ideas and opinions of ASCO®.
