Faculty of Health Sciences, University of Sydney, PO Box 170, Lidcombe, Sydney, 1825, New South Wales, Australia.
Support Care Cancer. 2013 Aug;21(8):2207-15. doi: 10.1007/s00520-013-1770-2. Epub 2013 Mar 15.
The aim was to better understand the incidence, time course and risk factors for swelling in the arm on the side of surgery over the first year following surgery for breast cancer.
Women (n = 160) were assessed 1 month following surgery and then randomised to the exercise or control group. Reassessment occurred 3, 9 and 15 months following surgery. Potential risk factors for swelling included age, body mass index, side of surgery and surgical and medical treatments for their breast cancer, physical measures of shoulder range of motion and strength, inter-limb arm circumference difference and the group to which they were randomised. Swelling was determined using bioimpedance spectroscopy with reference to previously established cut-offs for lymphoedema.
The number of women with swelling at 3, 9 and 15 months was 15, 15 and 13, respectively; however, at 15 months only 5/13 presented with swelling in either of the preceding assessments. The risk of swelling increased at 3, 9 and 15 months for each centimetre increase in the baseline inter-limb difference in sum of arm circumferences by 1.30, 1.17 and 1.14. In addition, risk of swelling at 3 months was 2.6 times greater for women in the control group; at 9 months, 7 times greater for women who had taxane-based chemotherapy; and at 15 months, the risk increased 1.16 times for each day the drain was in situ.
Swelling in the first year is likely to be transient, and factors including exercise and taxane chemotherapy affect the risk of developing swelling.
旨在更好地了解乳腺癌手术后第一年手臂手术侧肿胀的发生率、时程和危险因素。
160 名女性在手术后 1 个月进行评估，然后随机分为运动组或对照组。手术后 3、9 和 15 个月进行重新评估。肿胀的潜在危险因素包括年龄、体重指数、手术侧、乳腺癌的手术和医疗治疗、肩部活动范围和力量的物理测量、肢体间臂围差以及随机分组。肿胀是通过生物阻抗光谱法确定的，参考先前建立的淋巴水肿临界点。
3、9 和 15 个月时肿胀的女性人数分别为 15、15 和 13，但只有 13/15 在之前的评估中有肿胀。基线肢体间总和臂围差每增加 1 厘米，3、9 和 15 个月肿胀的风险分别增加 1.30、1.17 和 1.14。此外，对照组女性 3 个月肿胀的风险增加 2.6 倍；9 个月时，接受紫杉烷类化疗的女性风险增加 7 倍；15 个月时，引流管在位时间每增加一天，风险增加 1.16 倍。
术后第一年的肿胀可能是短暂的，运动和紫杉烷类化疗等因素会影响肿胀的风险。
