Risk factors for breast cancer-related upper extremity lymphedema: Is immediate autologous breast reconstruction one of them?

Abstract

<jats:title>Abstract</jats:title><jats:p>Breast cancer related upper extremity lymphedema (BCRL) reduces the quality of life of those who have had surgery for breast cancer. The aim of this study is to evaluate the risk factors for BCRL and determine whether immediate autologous tissue breast reconstruction is one of them. A case control study was conducted comparing patients with BCRL (n=97) to surgically treated breast cancer patients without BCRL (control, n=126). The groups were matched for age, type of breast surgery and radiation therapy. Postoperative upper extremity infection, body mass index (BMI), occupation (level of hand-use), and immediate autologous tissue breast reconstruction were investigated as a risk factor of BCRL. Mastectomy was performed on 47.6 % (n=60) and 37.2% (n=36) of patients in the control and the BCRL groups, respectively. Eight patients (13.3%) had immediate autologous tissue breast reconstruction in the control mastectomy group. Six of 36 BCRL patients (16.7%) underwent mastectomy with immediate autologous tissue breast reconstruction. There was no significant difference between groups with respect to incidence or method of immediate reconstruction (p=0.65). Patient occupation (level of hand use) was found to be positively correlated to development of BCRL (p=0.0001). Upper extremity infection rate was 22.7% in the BCRL group and 4.0% in the controls (p=0.0001). The mean BMI in the control and BCRL groups 26.8 kg/m2 and 29.1kg/m2, respectively (p=0.003). In conclusion, in this study characteristics positively associated with development of BCRL included occupation, infection, and increased BMI. Immediate reconstruction of the breast was not found as a risk factor for BCRL. However larger studies are needed, to further evaluate the effect of breast reconstruction on BCRL.</jats:p>

The role of occupational upper extremity use in breast cancer related upper extremity lymphedema

“…All eligible individuals were enrolled in the study. In our two previous studies [1,8], lymphedema symptoms and therapy needs in the study control groups were significantly lower than the BRCL patient groups (p < 0.001). Therefore, this study focused on evaluating different occupational characteristics within BCRL patient groups.…”

“…We reported in our previous study that infection of the arm, BMI, and level of hand use are Table 4 Occupation patient groups' symptom related therapy needs significant predictors for BCRL [1]. Another study from our group revealed that occupation, BMI, and postoperative upper extremity infection were risk factors for BCRL but the immediate flap-based breast reconstruction was not [8]. BCRL potential risk factors are grouped into three classes.…”

“…Our study group previously revealed that level of hand use is an important risk factor for BCRL [1,8]., and we classified hand use as low, medium, and high according to the occupation classification [1]. In this study, we used the modified classification of the level of hand use with more objective criteria such as daily total work period and continuous hand usage per hour [8].…”

Investigation of Experiences of Women Who Developed Lymphedema Related to Breast Cancer Treatment

“…Bu sonuç, hastaların lenfödemi, farklı toplumlarda da benzer belirtilerle fark ettiğini göstermektedir. Lenfödem nedenlerini inceleyen çalışmalarda kadınlar; bizim çalışmamızla benzer olarak lenfödem nedenlerini meme kanseri tedavisi, ağır kaldırma, yanlış egzersiz yapma, böcek sokmaları, güneş yanıkları, ve allerjik reaksiyonlar olarak belirtmişlerdir (6, 9) Literatürde, üst kolda enfeksiyonun, ve kolun fazla kullanımının meme kanseri ile ilgili lenfödem gelişimini etkilediği gösterilmiştir (19,20). Yurt dışında yapılan çalışmalardan farklı olarak bu çalışmada, keselenme algılanan lenfödem nedeni olarak belirtilmiştir.…”

The Interventional Effect of Combined Reducing Occupational Upper Extremity Use and Pneumatic Pump on Breast Cancer Related Lymphedema

“…It was reported that the occupation of patients which determine the level of hand use is one of the important risk factor for BCRL (Gur et al, 2009). In the current work; we applied the standard occupation classification system 2000 depending on the time of continuous hand usage and the daily total work period.…”