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The long‐term risk of upper‐extremity lymphedema is two‐fold higher in breast cancer patients than in melanoma patients
Author(s) -
Voss Rachel K.,
Cromwell Kate D.,
Chiang YiJu,
Armer Jane M.,
Ross Merrick I.,
Lee Jeffrey E.,
Gershenwald Jeffrey E.,
Stewart Bob R.,
Shaitelman Simona F.,
Cormier Janice N.
Publication year - 2015
Publication title -
journal of surgical oncology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.201
H-Index - 111
eISSN - 1096-9098
pISSN - 0022-4790
DOI - 10.1002/jso.24068
Subject(s) - medicine , lymphedema , breast cancer , oncology , melanoma , surgery , cancer , cancer research
Background and Objectives We assessed the cumulative incidence, symptoms, and risk factors for upper‐extremity lymphedema in breast cancer and melanoma patients undergoing sentinel lymph node biopsy or axillary lymph node dissection. Methods Patients were recruited preoperatively (time 0) and assessed at 6, 12, and 18 months postoperatively. Limb volume change (LVC) was measured by perometry. Lymphedema was categorized as none, mild (LVC 5–9.9%), or moderate/severe (LVC≥10%). Symptoms were assessed with a validated lymphedema instrument. Longitudinal logistic regression analyses were conducted to identify risk factors associated with moderate/severe lymphedema. Results Among 205 breast cancer and 144 melanoma patients, the cumulative incidence of moderate/severe lymphedema at 18 months was 36.5% and 35.0%, respectively. However, in adjusted analyses, factors associated with moderate/severe lymphedema were breast cancer (OR 2.0, P = 0.03), body mass index ≥30 kg/m 2 (OR 1.6, P = 0.04), greater number of lymph nodes removed (OR 1.05, P < 0.01), and longer interval since surgery (OR 2.33 at 18 months, P < 0.01). Conclusions Lymphedema incidence increased over time in both cohorts. However, the adjusted risk of moderate/severe lymphedema was two‐fold higher in breast cancer patients. These results may be attributed to surgical treatment of the primary tumor in the breast and more frequent use of radiation. J. Surg. Oncol. 2015;112:834–840 . © 2015 Wiley Periodicals, Inc.