Case-control study to evaluate predictors of lymphedema after breast cancer surgery

[lymphedemapeople]

Case-control study to evaluate predictors of lymphedema after breast
cancer surgery

Oncol Nurs Forum. 2009 Mar

Swenson KK, Nissen MJ, Leach JW, Post-White J.
Park Nicollet Institute. karen....@parknicollet.com

PURPOSE/OBJECTIVES: To identify risk factors for lymphedema after
breast cancer surgery. DESIGN: Multisite case-control study.

SETTING: Lymphedema clinics in the upper midwestern region of the
United States. SAMPLE: 94 patients with lymphedema and 94 controls
without lymphedema, matched on type of axillary surgery and surgery
date.

METHODS: The Measure of Arm Symptom Survey, a patient-completed tool,
assessed potential risk factors for lymphedema. Severity of lymphedema
was measured by arm circumference, and disease and treatment factors
were collected via chart review.

MAIN RESEARCH VARIABLES: Risk factors for lymphedema after breast
cancer surgery.

FINDINGS: On univariate analysis, patients with lymphedema were more
likely than controls to be overweight (body mass index >or= 25) (p =
0.009). They also were more likely to have had axillary radiation (p =
0.011), mastectomy (p = 0.008), chemotherapy (p = 0.033), more
positive nodes (p = 0.009), fluid aspirations after surgery (p =
0.005), and active cancer status (p = 0.008). Strength training (p =
0.014) and air travel (p = 0.0005) were associated with less
lymphedema occurrence. On multivariate analysis, the only factor
significantly associated with lymphedema was being overweight (p =
0.022).

CONCLUSIONS: Being overweight is an important modifiable risk factor
for lymphedema. Axillary radiation, more extensive surgery,
chemotherapy, and active cancer status also were predictive of
lymphedema.

IMPLICATIONS FOR NURSING: This study provides evidence that excess
weight contributes to lymphedema; strength training and airline travel
did not contribute to lymphedema.

Meta Press

http://ons.metapress.com/content/hq16x6622407521w/