Severe Lymphedema After Breast Cancer Surgery Associated With Obesity

Acute lymphedema following breast cancer surgery appears to be common, but most cases are mild or moderate, according to a new Chinese study presented at the 2019 San Antonio Breast Cancer Symposium. The study also found that women with breast cancer who are overweight or obese should be considered at high risk for acute lymphedema as well as those women who underwent axillary lymph node dissection (ALND) or experience anxiety after surgery.

The development of acute lymphedema is known to affect quality of life and lead to anxiety and depression. The researchers randomly selected 1613 patients who underwent curative breast cancer surgery during 2018 at a university cancer center in order to examine the prevalence and the degree of acute lymphedema in women with breast cancer.

For this study, all the women were categorized based on their degree of lymphedema (mild, moderate, or severe). The researchers used logistic regression models for univariate and multivariate analysis and examined psychological factors using the Hospital Anxiety and Depression Scale (HADS). They compared the HADS scores of women before surgery and at discharge in women who developed acute lymphedema with those who did not develop acute lymphedema.

The researchers identified 363 cases of acute lymphedema (22.50%), but 241 cases (66.39%) were considered mild degree and 104 cases (28.65%) were considered moderate. Only 18 cases (4.96%) were considered severe. Those who developed acute lymphedema were much more likely to be overweight or obese. They were also more likely to have undergone ALND and experienced a longer length of stay in the hospital compared with those women who did not develop acute lymphedema (all P <.05).

The study demonstrated that women who were diagnosed with severe acute lymphedema had higher rates of obesity and were more likely to suffer HADS-anxiety prior to surgery and at time of discharge compared with those women with mild or moderate acute lymphedema (all P <.05).  The factors that were associated with the development of acute lymphedema in a multivariate analysis were being overweight (P =.002), obesity (P =.019), ALND (P =.004) and HADS-anxiety at discharge (P =.002).

Reference

Ge L, Tang L, Li Y, Di G. Acute lymphedema after breast cancer surgery: prevalence, degree, associated factor. Poster presentation at: 2019 San Antonio Breast Cancer Symposium; December 10-14, 2019; San Antonio, TX. Abstract P5-10-05.