Body mass index increases the risk of breast cancer-related lymphedema at 6–18 months after surgery: a retrospective study

Chen, Hongbo; Wang, Huixue; Liu, Ning; Yu, Miao; Shang, Shaomei

doi:10.1007/s00520-023-07721-7

Cited by 2 publications

(2 citation statements)

References 29 publications

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“…Patients with a preoperative BMI ≥30 kg/m 2 had a significantly higher risk of lymphedema than those with a preoperative BMI < 25 kg/m 2 (odds ratio [OR] 95% confidence interval [CI] = 2.928 [1.565-5.480]). 13 Furthermore, sentinel lymph node biopsy (SLNB) 14 performed in overweight women was significantly associated with failed localization. [15][16][17] In addition, BC patients with a high BMI have a higher rate of lymph node metastasis.…”

Section: Introductionmentioning

confidence: 99%

“…Moreover, the risk of complications following breast surgery is higher among patients with obesity. Patients with a preoperative BMI ≥30 kg/m 2 had a significantly higher risk of lymphedema than those with a preoperative BMI < 25 kg/m 2 (odds ratio [OR] 95% confidence interval [CI] = 2.928 [1.565–5.480]) 13 . Furthermore, sentinel lymph node biopsy (SLNB) 14 performed in overweight women was significantly associated with failed localization 15–17 .…”

Section: Introductionmentioning

confidence: 99%

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Impact of obesity on sentinel lymph node biopsy outcomes and survival in breast cancer patients: A single‐center retrospective study

Pang,

Li,

Yin

et al. 2024

Cancer Medicine

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BackgroundSentinel lymph node biopsy (SLNB) is a common choice for axillary surgery in patients with early‐stage breast cancer (BC) who have clinically negative lymph nodes. Most research indicates that obesity is a prognostic factor for BC patients, but studies assessing its association with the rate of positive sentinel lymph nodes (SLN) and the prognosis of patients with early BC undergoing SLNB are limited.MethodsBetween 2013 and 2016, 7062 early‐stage BC patients from the Shanghai Cancer Center of Fudan University were included. Based on the Chinese Body Mass Index (BMI) classification standards, the patients were divided into three groups as follows: normal weight, overweight, and obese. Propensity score matching analysis was used to balance the baseline characteristics of the participants. Logistic regression analysis was used to determine the association between obesity and positive SLN rate. Cox regression analysis was used to investigate whether obesity was an independent prognostic factor for early‐stage BC patients who had undergone SLNB.ResultsNo significant association was observed between obesity and positive SLN rate in early‐stage BC patients who had undergone SLNB. However, multivariate analysis revealed that compared to patients with normal BMI, the overall survival (hazard ratio (HR) 2.240, 95% confidence interval (CI) 1.27–3.95, p = 0.005) and disease‐free survival (HR 1.750, 95% CI 1.16–2.62, p = 0.007) were poorer in patients with high BMI.ConclusionObesity is an independent prognostic factor for early‐stage BC patients who undergo SLNB; however, it does not affect the positive SLN rate.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Impact of obesity on sentinel lymph node biopsy outcomes and survival in breast cancer patients: A single‐center retrospective study

Pang,

Li,

Yin

et al. 2024

Cancer Medicine

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GLP-1 Agonists

Stanton,

Manasyan,

Banerjee

et al. 2024

Ann Plast Surg

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Background Glucagon-like peptide-1 (GLP-1) agonists, such as exenatide, liraglutide, dulaglutide, semaglutide, and tirzepatide, effectively manage type 2 diabetes by promoting insulin release, suppressing glucagon secretion, and enhancing glucose metabolism. They also aid weight reduction and cardiovascular health, potentially broadening their therapeutic scope. In plastic surgery, they hold promise for perioperative weight management and glycemic control, potentially impacting surgical outcomes. Methods A comprehensive review was conducted to assess GLP-1 agonists' utilization in plastic surgery. We analyzed relevant studies, meta-analyses, and trials to evaluate their benefits and limitations across surgical contexts, focusing on weight reduction, glycemic control, cardiovascular risk factors, and potential complications. Results Studies demonstrate GLP-1 agonists' versatility, spanning weight management, cardiovascular health, neurological disorders, and metabolic dysfunction-associated liver diseases. Comparative analyses highlight variations in glycemic control, weight loss, and cardiometabolic risk. Meta-analyses reveal significant reductions in hemoglobin A1C levels, especially with high-dose semaglutide (2 mg) and tirzepatide (15 mg). However, increased dosing may lead to gastrointestinal side effects and serious complications like pancreatitis and bowel obstruction. Notably, GLP-1 agonists' efficacy in weight reduction and glycemic control may impact perioperative management in plastic surgery, potentially expanding surgical candidacy for procedures like autologous flap-based breast reconstruction and influencing outcomes related to lymphedema. Concerns persist regarding venous thromboembolism and delayed gastric emptying, necessitating further investigation into bleeding and aspiration risk with anesthesia. Conclusions GLP-1 agonists offer advantages in perioperative weight management and glycemic control in plastic surgery patients. They may broaden surgical candidacy and mitigate lymphedema risk but require careful consideration of complications, particularly perioperative aspiration risk. Future research should focus on their specific impacts on surgical outcomes to optimize their integration into perioperative protocols effectively. Despite challenges, GLP-1 agonists promise to enhance surgical outcomes and patient care in plastic surgery.

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Body mass index increases the risk of breast cancer-related lymphedema at 6–18 months after surgery: a retrospective study

Cited by 2 publications

References 29 publications

Impact of obesity on sentinel lymph node biopsy outcomes and survival in breast cancer patients: A single‐center retrospective study

Impact of obesity on sentinel lymph node biopsy outcomes and survival in breast cancer patients: A single‐center retrospective study

GLP-1 Agonists

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