- 期刊
Incidence and Risk Factors Analysis of Lymphedema Secondary to Breast Cancer
乳癌後次發性淋巴水腫之發生率及危險因子分析
摘要
Lymphedema, the most significant complication of treatment for breast cancer, can result in substantial psychological and physical morbidity. However, no long-term follow-up lymphedema studies yet exist for Taiwanese breast cancer survivors. This study therefore focused on examining frequency and risk factors of lymphedema secondary to breast cancer in Taiwanese patients. Five hundred and seventy patients who received surgical treatment between 1994 and 2000 at Changhua Christian Hospital were retrospectively investigated in October 2002. The incidence of self-reported edema was 28 percent (161/570), and the incidence of lymphedema with circumference difference greater than 2cm was 8.1 percent (46/570). Eighty-four percent of patients developed lymphedema within 3 years of surgery, with a mean onset interval of 1.91 years. The accumulative incidence of lymphedema in the 7th follow-up year was 5 percent without radiotherapy and 23.5 percent with radiotherapy. Risk factors were radiotherapy (odds ratio, 7.49; p＜0.001) and modified radical mastectomy (MRM) (OR, 2.83; p=0.032). Radiation was significantly associated with lymphedema in the MRM group (p＜0.001), but not in the breast conserving surgery group. In the radiation subgroup, supraclavicular or axillary radiotherapy (p=0.022), and MRM (p=0.048) were significantly associated with lymphedema. Lymph nodes resection or metastasis, chemotherapy, year of diagnosis, and radiation dosage were not associated with lymphedema. Lymphedema was significantly associated with radiotherapy, axillary or supraclavicular irradiation, and MRM.
並列摘要
Lymphedema, the most significant complication of treatment for breast cancer, can result in substantial psychological and physical morbidity. However, no long-term follow-up lymphedema studies yet exist for Taiwanese breast cancer survivors. This study therefore focused on examining frequency and risk factors of lymphedema secondary to breast cancer in Taiwanese patients. Five hundred and seventy patients who received surgical treatment between 1994 and 2000 at Changhua Christian Hospital were retrospectively investigated in October 2002. The incidence of self-reported edema was 28 percent (161/570), and the incidence of lymphedema with circumference difference greater than 2cm was 8.1 percent (46/570). Eighty-four percent of patients developed lymphedema within 3 years of surgery, with a mean onset interval of 1.91 years. The accumulative incidence of lymphedema in the 7th follow-up year was 5 percent without radiotherapy and 23.5 percent with radiotherapy. Risk factors were radiotherapy (odds ratio, 7.49; p＜0.001) and modified radical mastectomy (MRM) (OR, 2.83; p=0.032). Radiation was significantly associated with lymphedema in the MRM group (p＜0.001), but not in the breast conserving surgery group. In the radiation subgroup, supraclavicular or axillary radiotherapy (p=0.022), and MRM (p=0.048) were significantly associated with lymphedema. Lymph nodes resection or metastasis, chemotherapy, year of diagnosis, and radiation dosage were not associated with lymphedema. Lymphedema was significantly associated with radiotherapy, axillary or supraclavicular irradiation, and MRM.