Department of Physical Medicine and Rehabilitation, Wan-Fang Hospital, Taipei Medical University, Taipei, Taiwan.
Department of General Surgery, Wan-Fang Hospital, Taipei Medical University, Taipei, Taiwan.
Breast. 2020 Aug;52:116-121. doi: 10.1016/j.breast.2020.05.007. Epub 2020 May 28.
Obesity has long been considered a risk factor for breast cancer-related lymphedema (BCRL), but the benefits of weight reduction in managing BCRL have not been clearly established.
To evaluate the beneficial effects of weight loss interventions (WLIs) on the reduction and prevention of BCRL.
We conducted a systematic review and meta-analysis by searching the PubMed, Scopus, and Embase databases from their earliest record to October 1st, 2019. We included randomized and non-randomized controlled trials involving adult patients with a history of breast cancer, that compared WLI groups with no-WLI groups, and provided quantitative measurements of lymphedema.
Initial literature search yielded 461 nonduplicate records. After exclusion based on title, abstract, and full-text review, four randomized controlled trials involving 460 participants were included for quantitative analysis. Our meta-analysis revealed a significant between-group mean difference (MD) regarding the volume of affected arm (MD = 244.7 mL, 95% confidence interval [CI]: 145.3-344.0) and volume of unaffected arm (MD = 234.5 mL, 95% CI: 146.9-322.1). However, a nonsignificant between-group MD of -0.07% (95% CI: 1.22-1.08) was observed regarding the interlimb volume difference at the end of the WLIs.
In patients with BCRL, WLIs are associated with decreased volume of the affected and unaffected arms but not with decreased severity of BCRL measured by interlimb difference in arm volume.
肥胖长期以来一直被认为是乳腺癌相关淋巴水肿（BCRL）的一个风险因素，但减轻体重对管理 BCRL 的益处尚未明确。
评估体重减轻干预（WLIs）对减少和预防 BCRL 的有益效果。
我们通过检索 PubMed、Scopus 和 Embase 数据库，从最早的记录到 2019 年 10 月 1 日进行了系统评价和荟萃分析。我们纳入了比较 WLI 组与无 WLI 组的、涉及有乳腺癌病史的成年患者的随机和非随机对照试验，并提供了淋巴水肿的定量测量值。
最初的文献检索产生了 461 条非重复记录。经过标题、摘要和全文审查排除后，纳入了四项涉及 460 名参与者的随机对照试验进行定量分析。我们的荟萃分析显示，两组间受累手臂体积的平均差异（MD）具有统计学意义（MD=244.7mL，95%置信区间[CI]：145.3-344.0）和未受累手臂体积的平均差异（MD=234.5mL，95% CI：146.9-322.1）。然而，在 WLIs 结束时，两组间肢体间体积差异的 MD 为-0.07%（95% CI：1.22-1.08），差异无统计学意义。
在患有 BCRL 的患者中，WLIs 与受累和未受累手臂的体积减少相关，但与通过手臂体积的肢体间差异测量的 BCRL 严重程度的减少无关。
