Risk Factors Of Upper Extremity Lymphedema In Women With Breast Cancer Following Surgery

Background:Upper extremity lymphedema is the major complication following breast cancer treatment which can persist a long period of time and affect breast cancer survivors’overall quality of life. Accurate estimates occurrence time and risk factors of lymphedema that can assist clinical nurses identify the patients who at high risk of developing lymphedema in early and take effectively interventions have great significance.Aims:This study is to explore the occurrence time and risk factors of upper extremity lymphedema following breast cancer surgery.Methods:A cross-sectional study on breast cancer related lymphedema was carried out at Chongqing Breast Cancer Center from July2009to June2010; a total of230patients meeting the inclusion criteria after surgery were recruited into the study. A validated patient self-reported lymphedema assessment questionnaire was used to diagnose lymphedema. Chi-square test, logistic regression analysis, the Kaplan-Meier survival analysis and Cox regression analysis were employed to investigate the occurrence time and risk factors of lymphedema.Results:About48%of the patients complained of varying degrees of lymphedema in the first18months after surgery during follow-up. Age, body mass index, pathological situation of lymph nodes, radiotherapy and chemotherapy were associated with lymphedema. The risk of lymphedema increased if patients who were overweight or obese, having positive lymph nodes, receiving postoperative radiotherapy. The risk of developing lymphedema decreased if patients who were younger than50years, receiving short-term preoperative chemotherapy.Conclusions:Upper extremity lymphedema is the major sequelae following breast cancer treatment.1. The average time for most breast cancer patients with secondary lymphedema was18months;2. Age, body mass index, pathological status of lymph nodes, radiotherapy and chemotherapy were associated with lymphedema development.3. Clinical nurses should be aware of the diagnosis, prevention and treatment of this complication, and provide patients with adequate and accurate lymphedema knowledge by supportive dialogues to prevent and manage this symptom, especially those who at high-risk of developing lymphedema.