King Hussein Cancer Center, Al-Jubeiha, P.O. Box 1269, Amman, 11941, Jordan,
Surg Today. 2014 Jan;44(1):100-6. doi: 10.1007/s00595-013-0494-8. Epub 2013 Feb 2.
Breast cancer-related lymphedema (LE) is relatively common. The aim of this study was to identify the risk factors involved in the development of this complication.
This was a cross-sectional study of breast cancer patients treated at our Center between 2004 and 2009. A total of 515 patients were included. Lymphedema was defined as a mid-arm or forearm circumference difference between both limbs of 2 cm or more.
The incidence of LE in this population was 21.4 %. Patients with a BMI of 25 or higher had a significantly higher risk of LE (p = 0.002). The presence of lymphovascular invasion (LVI) (p = 0.05) and the number of positive lymph nodes (LN) (p = 0.001) were both associated with LE. Patients who underwent axillary dissection (AD) had a significantly higher incidence of LE than patients who had a sentinel LN biopsy (25 vs. 4.5 %). Adjuvant radiotherapy was also a significant risk factor in patients who had a mastectomy (p = 0.003).
There are multiple risk factors for LE. Most of those factors can be influenced by early tumor detection. Early tumors are smaller with no LVI or axillary LN metastasis. They do not usually require AD or axillary radiotherapy, which are the strongest factors associated with the development of LE.
乳腺癌相关淋巴水肿（LE）较为常见。本研究旨在确定与该并发症发展相关的风险因素。
这是对 2004 年至 2009 年在我们中心治疗的乳腺癌患者进行的一项横断面研究。共纳入 515 例患者。淋巴水肿定义为双侧上肢中段或前臂周径差 2cm 或以上。
该人群中 LE 的发生率为 21.4%。BMI 为 25 或更高的患者 LE 风险显著更高（p=0.002）。存在淋巴血管侵犯（LVI）（p=0.05）和阳性淋巴结（LN）数量（p=0.001）均与 LE 相关。接受腋窝清扫术（AD）的患者 LE 发生率明显高于接受前哨淋巴结活检的患者（25%比 4.5%）。乳房切除术患者接受辅助放疗也是一个显著的风险因素（p=0.003）。
LE 存在多种风险因素。大多数这些因素可以通过早期肿瘤检测来影响。早期肿瘤较小，无 LVI 或腋窝 LN 转移。它们通常不需要 AD 或腋窝放疗，这是与 LE 发展最相关的两个因素。
