Epidemiology

Breast Cancer Research and Treatment

, Volume 113, Issue 2, pp 383-391

First online:

Risk factors for arm lymphedema following breast cancer diagnosis in Black women and White women

  • Kathleen A. MeeskeAffiliated withDepartment of Preventive Medicine, Keck School of Medicine of the University of Southern California
  • , Jane Sullivan-HalleyAffiliated withDepartment of Preventive Medicine, Keck School of Medicine of the University of Southern CaliforniaDepartment of Cancer Etiology, Division of Population Sciences, City of Hope National Medical Center and Comprehensive Cancer Center
  • , Ashley W. SmithAffiliated withApplied Research Program, Division of Cancer Control and Population Sciences, National Cancer Institute
  • , Anne McTiernanAffiliated withCancer Prevention Research Program, Fred Hutchinson Cancer Research Center
  • , Kathy B. BaumgartnerAffiliated withDepartment of Epidemiology & Population Health, University of Louisville
  • , Linda C. HarlanAffiliated withApplied Research Program, Division of Cancer Control and Population Sciences, National Cancer Institute
  • , Leslie BernsteinAffiliated withDepartment of Preventive Medicine, Keck School of Medicine of the University of Southern CaliforniaDepartment of Cancer Etiology, Division of Population Sciences, City of Hope National Medical Center and Comprehensive Cancer Center Email author 

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Abstract

Purpose Lymphedema of the arm is a potential complication of breast cancer therapy. This study examines pre-disposing factors that may operate in conjunction with treatment-related factors in the development of arm lymphedema in a large cohort of White and Black breast cancer survivors. Methods 494 women (271 White and 223 Black) with in situ to Stage III-A primary breast cancer completed a baseline interview within 18 months of diagnosis. Information on lymphedema was collected during a follow-up interview, conducted on average 50 months after diagnosis. Self-reported data were used to classify women with or without lymphedema. Multivariable logistic regression models were developed to identify risk factors for arm lymphedema. Results Arm lymphedema was associated with younger age at diagnosis (odds ratio, OR per year of age = 0.96; 95% confidence interval, CI = 0.93–0.99), positive history of hypertension (OR = 2.31; 95% CI = 1.38–3.88), obesity (OR for body mass index, BMI≥30 = 2.48; 95% CI = 1.05–5.84) and having had surgery where 10 or more lymph nodes were excised (OR = 2.16; 95% CI = 1.12–4.17). While Black women had higher prevalence of arm lymphedema than White women (28% vs. 21%), race was not associated with lymphedema risk in models adjusted for multiple factors (adjusted OR = 1.01; 95% CI = 0.63–1.63). Conclusion Risk of arm lymphedema did not differ significantly for Black and White women. Risk factors identified in this study offer opportunities for interventions (weight loss, control of blood pressure, use of sentinel node biopsy where possible) for reducing incidence of lymphedema or controlling the symptoms associated with this condition.

Keywords

Breast cancer survivors Black breast cancer survivors Arm lymphedema Risk factors for arm lymphedema Hypertension Body mass index Race