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常用慢性药理药物作为乳腺癌相关淋巴水肿的危险因素:一项观察性回顾性队列研究

Commonly Prescribed Chronic Pharmacological Medications as Risk Factors for Breast Cancer-Related Lymphedema: An Observational Retrospective Cohort Study.

作者信息

Borg Margherita B, Battaglia Marco, Mittino Laura, Loro Alberto, Lanzotti Laura, Scotti Lorenza, Gambaro Giuseppina, Invernizzi Marco, Baricich Alessio

机构信息

Physical and Rehabilitation Medicine, Department of Health Sciences, University of Eastern Piedmont, 28100 Novara, Italy.

Physical and Rehabilitation Medicine Unit, Azienda Ospedaliero-Universitaria "Maggiore della Carità", 28100 Novara, Italy.

出版信息

Healthcare (Basel). 2025 Mar 21;13(7):691. doi: 10.3390/healthcare13070691.

Abstract

: Breast cancer-related lymphedema (BCRL) is a significant complication of breast cancer (BC) treatment, characterized by swelling and fluid accumulation. Many risk factors have already been proven to be related to BCRL; meanwhile, many others are still debated and poorly investigated in the literature. This study investigated the potential involvement of commonly prescribed chronic medications in BCRL development. : This observational retrospective cohort study included 162 post-surgical breast cancer survivors attending an oncological rehabilitation outpatient service between January 2021 and April 2023. BCRL was diagnosed by physicians through clinical evaluation and objective measures (≥2 cm increase in circumferential girth measurements). Descriptive statistics summarized patient characteristics, and Cox regression models (univariable and multivariable) were employed to analyze risk factors for BCRL. : BCRL was observed in 53% of participants. The univariable model identified BMI (hazard ratio 1.07, 95% CI 1.02-1.11), overweight (BMI ≥ 25) (HR 1.46, 95% CI 0.95-2.25), and breast prosthesis implantation (HR 1.75, 95% CI 1.09-2.80) as potential risk factors for lymphedema. In the multivariable model, overweight (HR 2.90, 95% CI 1.18-7.14), hypertension (HR 5.09, 95% CI 1.88-13.79), radiotherapy (HR 3.67, 95% CI 1.43-9.38), and breast prosthesis implantation (HR 8.93, 95% CI 2.77-28.81) were identified as independent risk factors for BCRL. : The findings emphasize the need for further research to understand the role of chronic medications in BCRL risk comprehensively.

摘要

乳腺癌相关淋巴水肿(BCRL)是乳腺癌(BC)治疗的一种严重并发症,其特征为肿胀和液体蓄积。许多风险因素已被证实与BCRL相关;与此同时,其他许多因素仍存在争议,且在文献中研究较少。本研究调查了常用慢性药物在BCRL发生中的潜在作用。 :这项观察性回顾性队列研究纳入了2021年1月至2023年4月期间在肿瘤康复门诊就诊的162名乳腺癌术后幸存者。医生通过临床评估和客观测量(周径测量增加≥2厘米)诊断BCRL。描述性统计总结了患者特征,并采用Cox回归模型(单变量和多变量)分析BCRL的风险因素。 :53%的参与者出现了BCRL。单变量模型确定体重指数(风险比1.07,95%置信区间1.02 - 1.11)、超重(体重指数≥25)(风险比1.46,95%置信区间0.95 - 2.25)和乳房假体植入(风险比1.75,95%置信区间1.09 - 2.80)为淋巴水肿的潜在风险因素。在多变量模型中,超重(风险比2.90,95%置信区间1.18 - 7.14)、高血压(风险比5.09,95%置信区间1.88 - 13.79)、放疗(风险比3.67,95%置信区间1.43 - 9.38)和乳房假体植入(风险比8.93,95%置信区间2.77 - 28.81)被确定为BCRL的独立风险因素。 :研究结果强调需要进一步研究,以全面了解慢性药物在BCRL风险中的作用。

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Preoperative Risk Factors for Lymphedema in Inflammatory Breast Cancer.炎性乳腺癌淋巴水肿的术前危险因素。
J Reconstr Microsurg. 2024 May;40(4):311-317. doi: 10.1055/a-2182-1015. Epub 2023 Sep 26.
2
Risk Factors for Breast Cancer-Related Lymphedema: An Umbrella Review.乳腺癌相关性淋巴水肿的危险因素:伞式综述。
Ann Surg Oncol. 2024 Jan;31(1):284-302. doi: 10.1245/s10434-023-14277-7. Epub 2023 Sep 19.
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Advances in the prevention and treatment of breast cancer-related lymphedema.乳腺癌相关淋巴水肿的防治进展。
Breast Cancer Res Treat. 2023 Jul;200(1):1-14. doi: 10.1007/s10549-023-06947-7. Epub 2023 Apr 27.

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