Incidence and risk of arm oedema following treatment for breast cancer: a three-year follow-up study
Incidence and risk of arm oedema following treatment for breast cancer: a three-year follow-up study
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DOI：
10.1093/qjmed/hci053
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发表时间：
2005-05-01
影响因子：
13.3
通讯作者：
Harlow, W
中科院分区：
文献类型：
--
作者：
Clark, B;Sitzia, J;Harlow, W
背景：乳腺癌相关淋巴水肿是一种慢性疾病，估计发病率为6%至83%。脑水肿与多种危险因素有关。然而，这一证据存在方法上的缺陷，因此对临床实践的影响不大。目的：研究乳腺癌相关性手臂淋巴水肿的发病率和危险因素[医院皮肤穿刺、手术操作、体重指数（BMI）、年龄、腋窝淋巴结状态、腋窝淋巴结切除数量、优势侧放疗和手术]。设计：前瞻性观察研究，术前和术后定期测量肢体。方法：我们招募了251名接受过乳腺癌手术治疗的女性，包括腋窝淋巴结取样、切除或活检，年龄≥ 18岁，并且没有晚期疾病和心理共病。其中，188例（74.9%）可用于3年follow.Results：在随访中，39例（20.7%）已发展淋巴水肿。医院皮肤穿刺（vs.无）（RR 2.44，95%CI 1.33-4.47），乳房切除术（vs.广泛局部切除术或肿块切除术）（RR 2.04，95%CI 1.18-3.54），BMI >= 26（相对于BMI 19-26）（RR 2.02，95%CI 1.11-3.68）是仅有的显著风险因素。该样本中的5名女性在乳腺癌治疗后出现病症。在淋巴水肿的发展中确定了风险因素，在临床实践中应考虑到这些因素。
Background: Breast-cancer-related lymphoedema is a chronic condition with estimates of incidence ranging from 6 to 83%. Lymphoedema has been associated with a variety of risk factors. However, this evidence has suffered from methodological weaknesses, and so has had little impact upon clinical practice.Aim: To examine incidence and risk factors [hospital skin puncture, surgical procedure, Body Mass Index (BMI), age, axillary node status, number of axillary nodes removed, radiotherapy and surgery on dominant side] for breast cancer-related arm lymphoedema.Design: Prospective observational study, with measurement of limbs pre-operatively and at regular intervals post-operatively.Methods: We recruited 251 women who had surgical treatment for breast cancer that involved sampling, excision or biopsy of axillary nodes, aged >= 18 years, and free of advanced disease and psychological co-morbidities. Of these, 188 (74.9%) were available for 3-year follow-up.Results: At follow-up, 39 (20.7%) had developed lymphoedema. Hospital skin puncture (vs. none) (RR 2.44, 95%CI 1.33-4.47), mastectomy (vs. wide local excision or lumpectomy) (RR 2.04, 95%CI 1.18-3.54), and BMI >= 26 (vs. BMI 19-26) (RR 2.02, 95%CI 1.11-3.68) were the only significant risk factors.Discussion: Lymphoedema remains a significant clinical problem, with 1:5 women in this sample developing the condition following treatment for breast cancer. Risk factors are identified in the development of lymphoedema that should be taken into account in clinical practice.