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乳腺癌治疗后的体重增加和淋巴水肿:避免两难境地?

Weight Gain and Lymphedema After Breast Cancer Treatment: Avoiding the Catch-22?

机构信息

ICON Cancer Centre, Sydney Adventist Hospital, Wahroonga, Australia.

Australian Lymphoedema Education Research and Treatment (ALERT), Faculty of Medicine, Health and Human Sciences, Macquarie University, Sydney, Australia.

出版信息

Lymphat Res Biol. 2022 Aug;20(4):409-416. doi: 10.1089/lrb.2020.0048. Epub 2021 Nov 8.

Abstract

Overweight and obesity are strongly implicated in breast cancer (BC) development and are also a risk factor for BC-related lymphedema (BCRL). An online cross-sectional survey was conducted between November 2017 and January 2018. Analyses were restricted to women with localized BC, who provided information about BCRL ( = 238). Most women were not experiencing BCRL (55.46%). Mean self-reported weight at diagnosis was 68.55 kg for women without BCRL and 74.43 kg for women with BCRL ( = 0.0021). In this study, 50.9% with BCRL were overweight/obese at diagnosis (body mass index [BMI] ≥25) compared with 36.4% of women without BCRL ( = 0.003). For women without BCRL, 12.12% were classified as obese (BMI ≥30) versus 20.75% with BCRL. Women with BCRL were more likely to have gained >5% of body weight ( = 0.03), be currently overweight or obese ( = 0.004), and less active (48.11%) than they were at diagnosis than women without BCRL (33.33%) ( = 0.042). Having a structured exercise program, following a prescribed diet, and being accountable to someone else were identified as the main facilitators to successful weight loss and weight maintenance. Clinicians should consider obesity when personalizing axillary treatment and encourage lifestyle interventions and lymphedema screening after BC treatment.

摘要

超重和肥胖与乳腺癌(BC)的发生密切相关,也是乳腺癌相关淋巴水肿(BCRL)的一个危险因素。本研究于 2017 年 11 月至 2018 年 1 月期间开展了一项在线横断面调查。分析仅限于局部 BC 女性,她们提供了有关 BCRL 的信息( = 238)。大多数女性未发生 BCRL(55.46%)。无 BCRL 女性诊断时的平均自我报告体重为 68.55 kg,有 BCRL 女性为 74.43 kg( = 0.0021)。在本研究中,50.9%有 BCRL 的女性在诊断时超重/肥胖(BMI≥25),而无 BCRL 的女性为 36.4%( = 0.003)。无 BCRL 的女性中,12.12%被归类为肥胖(BMI≥30),而有 BCRL 的女性为 20.75%。与无 BCRL 的女性相比,有 BCRL 的女性更有可能体重增加>5%( = 0.03)、目前超重或肥胖( = 0.004),且活动量较少(48.11%),而不是诊断时的状态(33.33%)( = 0.042)。有结构化的锻炼计划、遵循规定的饮食和对他人负责被确定为成功减肥和保持体重的主要促进因素。临床医生在制定腋窝治疗方案时应考虑肥胖问题,并在 BC 治疗后鼓励进行生活方式干预和淋巴水肿筛查。

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