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

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Abstract

Purpose

Breast cancer-related lymphedema (BCRL) is an incurable complication occurring after breast cancer treatment. The influence of obesity/overweight on the development of BCRL at different points after surgery was seldom verified. We aimed to determine the cut-off BMI/weight value associated with an increased risk of BCRL at different postoperative time in Chinese breast cancer survivors.

Methods

Patients who underwent breast surgery plus axillary lymph node dissection (ALND) were retrospectively evaluated. Disease and treatment characteristics of participants were collected. BCRL was diagnosed by circumference measurements. Univariate and multivariable logistic regression was used to assess the relationship of lymphedema risk with BMI/weight and other disease- and treatment-related factors.

Results

518 patients were included. Lymphedema occurred more frequently among breast cancer patients with preoperative BMI ≥ 25 kg/m2 (37.88%) than among those with preoperative BMI < 25 kg/m2(23.32%), with significant differences at 6–12 and 12–18 months after surgery (χ2 = 23.183, P = 0.000; χ2 = 5.279, P = 0.022). By multivariable logistics analysis, preoperative BMI ≥ 30 kg/m2 presented a significantly greater risk of lymphedema than a preoperative BMI < 25 kg/m2 (OR [95% CI] = 2.928 [1.565, 5.480]). Other factors, including radiation (breast/chest wall + axilla vs. none: OR [95% CI] = 3.723[2.271–6.104]), was an independent risk factor for lymphedema.

Conclusions

Preoperative obesity was an independent risk factor for BCRL in Chinese breast cancer survivors, and a preoperative BMI ≥ 25 kg/m2 indicated greater likelihood of lymphedema development within 6–18 months postoperatively.

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Data availability

Data are not available.

Abbreviations

BMI:

Body mass index

CI:

Confidence interval

BCRL:

Breast cancer-related lymphedema

ALND:

Axillary lymph-node dissection

SD:

Standard deviation

WHO:

World Health Organization

RLND:

Regional lymph node irradiation

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Authors and Affiliations

  1. School of Nursing, Wannan Medical College, Wuhu, 241002, China

    Ling Wang, Yuanzhen Li, Huixue Wang, Ning Liu & Miao Yu

  2. School of Nursing, Peking University, Haidian District, 38 Xueyuan Road, Beijing, 100191, China

    Ling Wang, Hongbo Chen & Shaomei Shang

Authors
  1. Ling Wang
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  2. Hongbo Chen
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  3. Yuanzhen Li
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  4. Huixue Wang
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  5. Ning Liu
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  6. Miao Yu
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  7. Shaomei Shang
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Contributions

Shaomei Shang and Ling Wang were responsible for the study design. Ning Liu and Miao Yu performed data collection. Hongbo Chen and Yuanzhen Li performed data analysis. Ling Wang, Hongbo Chen, Yuanzhen Li, and Huixue Wang were responsible for the drafting of the manuscript. Shaomei Shang made critical revision of the manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Shaomei Shang.

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This study had appropriate ethical approval (the Peking University Research Ethics Committee, IRB00001052-21051).

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Written informed consent was obtained from the parents.

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No participants are identifiable.

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The authors declare no competing interests.

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Wang, L., Chen, H., Li, Y. et al. Body mass index increases the risk of breast cancer-related lymphedema at 6–18 months after surgery: a retrospective study. Support Care Cancer 31, 278 (2023). https://doi.org/10.1007/s00520-023-07721-7

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