Correlates of Lymphedema in Women with Breast Cancer: a Case Control Study in Shiraz, Southern Iran

Honarvar, Behnam; Sayar, Negin; Tahmasebi, Sedigheh; Zakeri, Zeinab; Talei, Asra; Rostami, Sara; Khademi, Sahar; Sarvestani, Amene Sabzi; Sekhavati, Eghbal

doi:10.7314/apjcp.2016.17.s3.81

Cited by 5 publications

(21 citation statements)

References 15 publications

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“…Modi ed radical mastectomy was associated with an OR of 4.3 (95% CIs: 2.3 -7.9) risk than those who did not and participants who received radiotherapy had an OR of 3.9 (95% CIs: 1.8 -8.2) risk of developing arm lymphedema compared with those who did not (52). The length of time after surgery for breast cancer was also reported to be 9.7 times higher among breast cancer women who had surgery more than 5 years as compared to those with less years (31).…”

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confidence: 95%

“…One study (34) reported that individuals with body mass index (BMI) of ≥30 were 6.64 times more likely to develop arm lymphedema than those with BMI ≤17.9. The risk of developing arm lymphedema among breast cancer women with BMI ≥25 ranges from the odds ratio (OR) of 1.5 to 5.9 compared to participants with BMI < 25 (34,38,41,48,52). We obtained a pooled effect estimate OR of 1.98, 95% con dence interval (CI):…”

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confidence: 99%

“…[Insert Figure 5] Axillary radiotherapy treatment is a signi cant risk with an OR ranging from 2.7 to 4.4 (21,38,42). Four studies examined the risk of developing arm lymphedema associated with higher number of lymph node removal among breast cancer survivors (21,38,48,52). The removal of lymph nodes of >25 during mastectomy was associated with a risk of developing arm lymphedema ] among breast cancer woman compared with when less number of lymph nodes were removed (21).…”

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confidence: 99%

“…Other risk factors identi ed to signi cantly affect lymphedema among breast cancer survivors include: past history of limb damage had an OR of 1.7 (95% CIs: 0.9 -3.1) (52), presence of a co-morbid condition with a HR of 0.1593 (95% CIs: 1.1441 -2.9369) (43), post radiotherapy moist desquamation had an OR of 4.34 (95% CIs: 1.07-17.65) (45), and presence of seroma after breast cancer surgery (31). Women with breast cancer tumour invasion were 13.7 times at risk of developing arm lymphedema compared to those women who did not receive tumour invasion (52). Cancer stage was not signi cant in arm lymphedema following breast cancer treatment (31, 45) (refer to Table 3).…”

Section: [Insert Figures 2 and 3]mentioning

confidence: 99%

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Prevalence and incidence of cancer related lymphedema in low and middle-income countries: A systematic review and meta-analysis.

Torgbenu

Luckett

Buhagiar

et al. 2020

Preprint

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Abstract Background Little is known about the prevalence and incidence in low and middle-income countries (LMICs) of secondary lymphedema due to cancer. This study aims to estimate the prevalence and incidence in LMICs of secondary lymphedema related to cancer and/or its treatment(s) and identify risk factors. Method A systematic review and meta-analysis was conducted. Medline, EMBASE and CINAHL were searched in June 2019 for peer-reviewed articles that assessed prevalence and/or incidence of cancer-related lymphedema in LMICs. Risk of bias was assessed using the Joanna Briggs Institute Critical Appraisal Checklist for Prevalence Studies. Estimates of pooled prevalence and incidence estimates were calculated with 95% confidence intervals (CI), with sub-group analyses grouping studies according to: country of origin, study design, risk of bias, setting, treatment, and lymphedema site and measurement. Heterogeneity was measured using X ² and I 2 , with interpretation guided by the Cochrane Handbook for Systematic Reviews. Results Of 8766 articles, 36 were included. Most reported on arm lymphedema secondary to breast cancer treatment (n=31), with the remainder reporting on leg lymphedema following gynecological cancer treatment (n=5). Arm lymphedema was mostly measured by arm circumference (n=16/31 studies), and leg lymphedema through self-report (n=3/5 studies). Eight studies used more than one lymphedema measurement. Only two studies that measured prevalence of leg lymphedema could be included in a meta-analysis (pooled prevalence =10.0%, 95%CI 7.0 – 13.0, I 2 =0%). The pooled prevalence of arm lymphedema was 27%, with considerable heterogeneity (95%CI 20.0 – 34.0, I 2 =94.69%, n =13 studies). The pooled incidence for arm lymphedema was 21%, also with considerable heterogeneity (95%CI 15.0 – 26.0, I 2 =95.29%, n =11 studies). There was evidence that higher BMI (>25) was associated with increased risk of arm lymphedema (OR: 1.98, 95%CI 1.45 – 2.70, I 2 =84.0%, P< 0.0001, n =4 studies). Conclusion Better understanding the factors that contribute to variability in cancer-related arm lymphedema in LMICs is an important first step to developing targeted interventions to improve quality of life. Standardising measurement of lymphedema globally and better reporting would enable comparison within the context of information about cancer treatments and lymphedema care.

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Section: [Insert Figures 2 and 3]mentioning

confidence: 95%

Section: [Insert Figures 2 and 3]mentioning

confidence: 99%

Section: [Insert Figures 2 and 3]mentioning

confidence: 99%

Section: [Insert Figures 2 and 3]mentioning

confidence: 99%

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Prevalence and incidence of cancer related lymphedema in low and middle-income countries: A systematic review and meta-analysis.

Torgbenu

Luckett

Buhagiar

et al. 2020

Preprint

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“…All studies were conducted between 2001 and 2019 and three studies [22][23][24] were reported in non-English language publications (Refer to Table 2). While the majority of studies were conducted in Brazil (n = 12) and Turkey (n = 9), most other regions with LMIC were represented, including: South America (n = 12) [5,20,24,[32][33][34][35][36][37][38][39]49] [47,48,54] and East Asia and Pacific (n = 1) [46].…”

Section: Characteristics Of Included Studiesmentioning

confidence: 99%

Prevalence and incidence of cancer related lymphedema in low and middle-income countries: a systematic review and meta-analysis

et al. 2020

View full text Add to dashboard Cite

Background: Little is known about the prevalence and incidence in low and middle-income countries (LMICs) of secondary lymphedema due to cancer. The purpose of the study is to estimate the prevalence and incidence in LMICs of secondary lymphedema related to cancer and/or its treatment(s) and identify risk factors. Method: A systematic review and meta-analysis was conducted. Medline, EMBASE and CINAHL were searched in June 2019 for peer-reviewed articles that assessed prevalence and/or incidence of cancer-related lymphedema in LMICs. Risk of bias was assessed using the Joanna Briggs Institute Critical Appraisal Checklist for Prevalence Studies. Estimates of pooled prevalence and incidence estimates were calculated with 95% confidence intervals (CI), with subgroup analyses grouping studies according to: country of origin, study design, risk of bias, setting, treatment, and lymphedema site and measurement. Heterogeneity was measured using X 2 and I 2 , with interpretation guided by the Cochrane Handbook for Systematic Reviews. Results: Of 8766 articles, 36 were included. Most reported on arm lymphedema secondary to breast cancer treatment (n = 31), with the remainder reporting on leg lymphedema following gynecological cancer treatment (n = 5). Arm lymphedema was mostly measured by arm circumference (n = 16/31 studies), and leg lymphedema through self-report (n = 3/5 studies). Eight studies used more than one lymphedema measurement. Only two studies that measured prevalence of leg lymphedema could be included in a meta-analysis (pooled prevalence = 10.0, 95% CI 7.0-13.0, I 2 = 0%). The pooled prevalence of arm lymphedema was 27%, with considerable heterogeneity (95% CI 20.0-34.0, I 2 = 94.69%, n = 13 studies). The pooled incidence for arm lymphedema was 21%, also with considerable heterogeneity (95% CI 15.0-26.0, I 2 = 95.29%, n = 11 studies). There was evidence that higher body mass index (> 25) was associated with increased risk of arm lymphedema (OR: 1.98, 95% CI 1.45-2.70, I 2 = 84.0%, P < 0.0001, n = 4 studies).

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Self‐reported signs and symptoms of secondary upper limb lymphoedema related to breast cancer treatment: Systematic review

et al. 2021

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Introduction Breast cancer survivors with secondary upper limb lymphoedema (ULL) may report a wide range of self‐reported symptoms. At the moment, no overview of ULL‐specific symptoms is available. The first aim, therefore, was to compare the prevalence rates of self‐reported signs and symptoms in people with and without secondary ULL due to breast cancer treatment. The second aim was to determine whether symptoms of lymphoedema could be predictive for the development of ULL. The third aim was to describe the association between the presence/severity of symptoms and the presence/severity of ULL. Methods A systematic search was conducted in Medline, Scopus, CINAHL and EMBASE databases, with key words related to breast cancer, symptoms and ULL. Results Twenty‐nine articles were eligible. The most frequently reported signs and symptoms were swelling (80.9%) and heaviness (66.7%) in the ULL group and tenderness (37%) and numbness (27%) in the non‐ULL group. Perceived larger arm size, as well as feelings of arm tightness, stiffness, puffiness, pain, sensory disturbances and functional changes were predictive for the development of ULL. Moderate correlations were found between the presence of swelling, firmness in the past year and tightness now and severity of ULL. There was also moderate correlation between the presence of swelling and heaviness now and the presence of ULL. Conclusions Swelling and heaviness are the most commonly reported symptoms in patients with ULL. The presences of these two symptoms are moderately correlated with the presence and/or severity of ULL. Although limited information regarding the predictive self‐reported symptoms for the development of ULL was found. Further research with standardised definitions of ULL and validated questionnaires for self‐reported signs and symptoms are needed to confirm which signs and symptoms are related to ULL and which to other upper limb morbidities.

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Correlates of Lymphedema in Women with Breast Cancer: a Case Control Study in Shiraz, Southern Iran

Cited by 5 publications

References 15 publications

Prevalence and incidence of cancer related lymphedema in low and middle-income countries: A systematic review and meta-analysis.

Prevalence and incidence of cancer related lymphedema in low and middle-income countries: A systematic review and meta-analysis.

Prevalence and incidence of cancer related lymphedema in low and middle-income countries: a systematic review and meta-analysis

Self‐reported signs and symptoms of secondary upper limb lymphoedema related to breast cancer treatment: Systematic review

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