Jeong Sung Hoon, Chun Seong Min, Kim Miji, Lee Ye Seol, Kim Jisun, Leigh Ja-Ho, Choi Yoon-Hee
Department of Rehabilitation Medicine, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul, Republic of Korea.
National Traffic Injury Rehabilitation Research Institute, National Traffic Injury Rehabilitation Hospital, Yangpyeong, 12564, Republic of Korea.
BMC Cancer. 2025 Jan 22;25(1):114. doi: 10.1186/s12885-025-13513-5.
As the roles of chemotherapy (Chemo) and radiation therapy (Radio) in the definitive treatment of breast cancer have expanded, a broader understanding of the factors associated with breast cancer-related lymphedema (BCRL) has become increasingly essential. Therefore, we investigated the association between multimodality treatment and the risk of BCRL.
In this retrospective study conducted using National Health Insurance data and the Korea National Cancer Incidence Database (2006-2017), 114,638 participants who underwent Surgery (Surg) or Chemo within 6 months after breast cancer diagnosis were enrolled, and the effect of multimodality treatment on the risk of BCRL was analyzed using the Cox proportional-hazards model. Multimodality treatment administered through six months of treatment was grouped as only Surg; Surg/Chemo; Surg/ Chemo/Radio; Surg/Radio; only Chemo; and Chemo/Radio.
The risk of BCRL was higher in the Surg/Chemo group (hazard ratio [HR]: 1.54, 95% confidence interval [CI]: 1.43-1.65), Surg/Chemo/Radio group (HR: 1.51, 95% CI: 1.43-1.65), only Chemo group (HR: 1.58, 95% CI: 1.45-1.71), and Chemo/Radio group (HR: 1.13, 95% CI: 1.00-1.29) in comparison with the only Surg group.
BCRL occurrence is an after-effect of complex breast cancer treatments, and the risk may vary depending on the treatment method, including Surg, chemo, and radio. Our findings suggest that multidisciplinary strategies are required to minimize the risk of BCRL development in patients with breast cancer.
随着化疗（Chemo）和放射治疗（Radio）在乳腺癌根治性治疗中的作用不断扩大，更全面地了解与乳腺癌相关淋巴水肿（BCRL）的相关因素变得愈发重要。因此，我们研究了多模式治疗与BCRL风险之间的关联。
在这项使用国民健康保险数据和韩国国家癌症发病率数据库（2006 - 2017年）进行的回顾性研究中，纳入了114,638名在乳腺癌诊断后6个月内接受手术（Surg）或化疗的参与者，并使用Cox比例风险模型分析多模式治疗对BCRL风险的影响。在六个月的治疗期间进行的多模式治疗分为仅手术；手术/化疗；手术/化疗/放疗；手术/放疗；仅化疗；化疗/放疗。
与仅手术组相比，手术/化疗组（风险比[HR]：1.54，95%置信区间[CI]：1.43 - 1.65）、手术/化疗/放疗组（HR：1.51，95%CI：1.43 - 1.65）、仅化疗组（HR：1.58，95%CI：1.45 - 1.71）和化疗/放疗组（HR：1.13，95%CI：1.00 - 1.29）的BCRL风险更高。
BCRL的发生是复杂乳腺癌治疗的后遗症，风险可能因包括手术、化疗和放疗在内的治疗方法而异。我们的研究结果表明，需要采取多学科策略以将乳腺癌患者发生BCRL的风险降至最低。
