Body mass index increases the risk of breast cancer-related lymphedema at 6-18 months after surgery: a retrospective study

PurposeBreast cancer-related lymphedema (BCRL) is an incurable complication occurring after breast cancer treatment. The influence of obesity/overweight on the development of BCRL at different points after surgery was seldom verified. We aimed to determine the cut-off BMI/weight value associated with an increased risk of BCRL at different postoperative time in Chinese breast cancer survivors.MethodsPatients who underwent breast surgery plus axillary lymph node dissection (ALND) were retrospectively evaluated. Disease and treatment characteristics of participants were collected. BCRL was diagnosed by circumference measurements. Univariate and multivariable logistic regression was used to assess the relationship of lymphedema risk with BMI/weight and other disease- and treatment-related factors.Results518 patients were included. Lymphedema occurred more frequently among breast cancer patients with preoperative BMI >= 25 kg/m(2) (37.88%) than among those with preoperative BMI < 25 kg/m(2)(23.32%), with significant differences at 6-12 and 12-18 months after surgery (chi(2) = 23.183, P = 0.000; chi(2) = 5.279, P = 0.022). By multivariable logistics analysis, preoperative BMI >= 30 kg/m(2) presented a significantly greater risk of lymphedema than a preoperative BMI < 25 kg/m(2) (OR [95% CI] = 2.928 [1.565, 5.480]). Other factors, including radiation (breast/chest wall + axilla vs. none: OR [95% CI] = 3.723[2.271-6.104]), was an independent risk factor for lymphedema.ConclusionsPreoperative obesity was an independent risk factor for BCRL in Chinese breast cancer survivors, and a preoperative BMI >= 25 kg/m(2) indicated greater likelihood of lymphedema development within 6-18 months postoperatively.

Automated summary

This study investigated the impact of obesity/overweight on the development of breast cancer-related lymphedema (BCRL) at different time points after surgery in Chinese breast cancer survivors. The results showed that patients with a preoperative BMI >= 25 kg/m(2) had a significantly higher occurrence of lymphedema compared to those with a preoperative BMI < 25 kg/m(2), especially at 6-12 and 12-18 months after surgery. Multivariable logistic regression analysis confirmed that a preoperative BMI >= 30 kg/m(2) was significantly associated with an increased risk of lymphedema. In conclusion, preoperative obesity is an independent risk factor for BCRL in Chinese breast cancer survivors.