Skip to main content

Advertisement

SpringerLink
Log in

Body mass index and breast cancer treatment-related lymphedema

  • Short Communication
  • Published:
Supportive Care in Cancer Aims and scope Submit manuscript

Abstract

Purpose

The main purpose was to examine longitudinally the influence of body mass index (BMI) and obesity on the development of breast cancer treatment-related lymphedema. We asked, does elevated BMI increase lymphedema risk?

Methods

A secondary analysis was conducted on de-identified data collected from 138 newly diagnosed breast cancer survivors who had arm-volume measurements and symptom assessment at pre-treatment baseline and measurements up to 30 months post-surgery in a prospective longitudinal parent study. Arm volume and weight data, part of the information collected during each participant visit, were examined.

Results

Breast cancer survivors whose BMI was ≥30 at the time of breast cancer treatment were approximately 3.6 times more likely to develop lymphedema at 6 months or greater after diagnosis than those with a BMI < 30 at the time of cancer treatment (95% confidence interval, C.I., for odds ratio, O.R., 1.42–9.04; p = 0.007). Those with a general BMI increase or a BMI rise to 30 or greater during their first 30 months of survivorship were not more likely to develop late-onset lymphedema than those who did not have similar changes in BMI.

Conclusions

Pre-treatment BMI may be a risk factor for lymphedema. Weight gain post-treatment may not be. Further research is warranted.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

References

  1. Fajardo L (1994) Effects of ionizing radiation on lymph nodes. A review. Front Radiat Ther Oncol 28:37–45

    PubMed  CAS  Google Scholar 

  2. Meric F, Buchholz T, Mirza N, Vlastos G, Ames F, Ross M, Pollock R, Singletary S, Feig B, Kuerer H, Newman L, Perkins G, Strom E, McNeese M, Hortobagyi G, Hunt K (2002) Long-term complications associated with breast-conservation surgery and radiotherapy. Ann Surg Oncol 9:543–549. doi:10.1007/bf02573889

    Article  PubMed  Google Scholar 

  3. Goyal A, Newcombe R, Chhabra A, Mansel R (2008) Morbidity in breast cancer patients with sentinel node metastases undergoing delayed axillary lymph node dissection (ALND) compared with immediate ALND. Ann Surg Oncol 15:262–267. doi:10.1245/s10434-007-9593-3

    Article  PubMed  Google Scholar 

  4. Ridner S (2002) Breast cancer lymphedema: pathophysiology and risk reduction guidelines. Oncol Nurs Forum 29:1285–1293. doi:10.1188/02.ONF.1285-1293

    Article  PubMed  Google Scholar 

  5. Ridner S (2005) Quality of life and a symptom cluster associated with breast cancer treatment-related lymphedema. Support Care Cancer 13:904–911. doi:10.1007/s00520-005-0810-y

    Article  PubMed  Google Scholar 

  6. Rockson SG (2001) Lymphedema. Am J Med 110:288–295. doi:10.1016/s0002-9343(00)00727-0

    Article  PubMed  CAS  Google Scholar 

  7. Chachaj A, Małyszczak K, Pyszel K, Lukas J, Tarkowski R, Pudełko M, Andrzejak R, Szuba A (2010) Physical and psychological impairments of women with upper limb lymphedema following breast cancer treatment. Psychooncology 19:299–305. doi:10.1002/pon.1573

    Article  PubMed  Google Scholar 

  8. Armer J, Stewart B, Shook R (2009) 30-month post-breast cancer treatment lymphoedema. J Lymphoedema 4:14–18

    PubMed  Google Scholar 

  9. Armer JM, Stewart BR (2005) A comparison of four diagnostic criteria for lymphedema in a post-breast cancer population. Lymphat Res Biol 3:208–217. doi:10.1089/lrb.2005.3.208

    Article  PubMed  Google Scholar 

  10. Clark B, Sitzia J, Harlow W (2005) Incidence and risk of arm oedema following treatment for breast cancer: a three-year follow-up study. QJM 98:343–348. doi:10.1093/qjmed/hci053

    Article  PubMed  CAS  Google Scholar 

  11. Kopanski Z, Wojewoda T, Wojewoda A, Schlegel-Zawadzka M, Wozniacka R, Suder A, Kosciuk T (2003) Influence of some anthropometric parameters on the risk of development of distal complications after mastectomy carried out because of breast carcinoma. Am J Hum Biol 15:433–439. doi:10.1002/ajhb.10158

    Article  PubMed  Google Scholar 

  12. Helyer LK, Varnic M, Le LW, Leong W, McCready D (2010) Obesity is a risk factor for developing postoperative lymphedema in breast cancer patients. Breast J 16:48–54. doi:10.1111/j.1524-4741.2009.00855.x

    Article  PubMed  Google Scholar 

  13. Mak S, Yeo W, Lee Y, Tse S, Ho F, Zee B, Chan E (2009) Risk factors for the initiation and aggravation of lymphoedema after axillary lymph node dissection for breast cancer. Hong Kong Med J 15:8–12

    PubMed  CAS  Google Scholar 

  14. Mak SS, Yeo W, Lee YM, Mo KF, Tse KY, Tse SM, Ho FP, Kwan WH (2008) Predictors of lymphedema in patients with breast cancer undergoing axillary lymph node dissection in Hong Kong. Nurs Res 57:416–425. doi:10.1097/NNR.0b013e31818c3de2

    Article  PubMed  Google Scholar 

  15. Bray G (2003) Risks of obesity. Endocrinol Metab Clin North Am 32:787–804. doi:10.1016/s0889-8529(03)00067-7

    Article  PubMed  Google Scholar 

  16. Hu FB (2003) Overweight and obesity in women: health risks and consequences. J Womens Health 12:163–172. doi:10.1089/154099903321576565

    Article  Google Scholar 

  17. Bray GA (2004) Medical consequences of obesity. J Clin Endocrinol Metab 89:2583–2589. doi:10.1210/jc.2004-0535

    Article  PubMed  CAS  Google Scholar 

  18. Meeske K, Sullivan-Halley J, Smith A, McTiernan A, Baumgartner K, Harlan L, Bernstein L (2009) Risk factors for arm lymphedema following breast cancer diagnosis in Black women and White women. Breast Cancer Res Treat 113:383–391. doi:10.1007/s10549-008-9940-5

    Article  PubMed  Google Scholar 

  19. Bunce I, Mirolo B, Hennessy J, Ward L, Jones L (1994) Post-mastectomy lymphoedema treatment and measurement. Med J Aust 161:125–128

    PubMed  CAS  Google Scholar 

  20. Stanton A, Holroyd B, Mortimer P, Levick J (1999) Comparison of microvascular filtration in human arms with and without postmastectomy oedema. Exp Physiol 84:405–419. doi:10.1017/S0958067099018102

    Article  PubMed  CAS  Google Scholar 

  21. Tierney S, Aslam M, Rennie K, Grace P (1996) Infrared optoelectronic volumetry, the ideal way to measure limb volume. Eur J Vasc Endovasc Surg 12:412–417. doi:10.1016/s1078-5884(96)80005-0

    Article  PubMed  CAS  Google Scholar 

  22. Armer JM, Radina ME, Porock D, Culbertson SD (2003) Predicting breast cancer-related lymphedema using self-reported symptoms. Nurs Res 52:370–379. doi:10.1097/00006199-200311000-00004

    Article  PubMed  Google Scholar 

  23. Mahamaneerat W, Shyu C, Stewart B, Armer J (2008) Breast cancer treatment, BMI, post-op swelling/lymphoedema. J Lymphoedema 3:38–44

    PubMed  Google Scholar 

  24. Petrek JA, Senie RT, Peters M, Rosen PP (2001) Lymphedema in a cohort of breast carcinoma survivors 20 years after diagnosis. Cancer 92:1368–1377. doi:10.1002/1097-0142(20010915)92:6<1368::aid-cncr1459>3.0.co;2-9

    Article  PubMed  CAS  Google Scholar 

  25. Stout Gergich NL, Pfalzer LA, McGarvey C, Springer B, Gerber LH, Soballe P (2008) Preoperative assessment enables the early diagnosis and successful treatment of lymphedema. Cancer 112:2809–2819. doi:10.1002/cncr.23494

    Article  PubMed  Google Scholar 

Download references

Acknowledgments

For Sheila H. Ridner, PhD, RN, FAAN, research was supported by a Vanderbilt University School of Nursing Oncology Postdoctoral Fellowship Award. For Bob R. Stewart, EdD, and Jane M. Armer, PhD, RN, FAAN, research was supported by NIH R01 NR05342 and MU PRIME C2720047 (Armer, PI), as well as Ellis Fischel Cancer Center research funds. The authors wish to thank the other members of the lymphedema research team, including research nurses, research assistants, and clinical collaborators at Ellis Fischel Cancer Center and, most importantly, the breast cancer survivors participating in the study.

Conflict of interest statement

None.

Role of the funding source

None.

Author information

Authors and Affiliations

  1. School of Nursing, Vanderbilt University, 460 21st Avenue South, 525 Godchaux Hall, Nashville, TN, 37240, USA

    Sheila H. Ridner & Mary S. Dietrich

  2. Department of Biostatistics, School of Medicine, Vanderbilt University, 460 21st Avenue South, 410 Godchaux Hall, Nashville, TN, 37240, USA

    Mary S. Dietrich

  3. Sinclair School of Nursing, Ellis Fischel Cancer Center, University of Missouri, DC 116.05 Suite 408 EFCC, Columbia, MO, 65211, USA

    Bob R. Stewart & Jane M. Armer

Authors
  1. Sheila H. Ridner
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Mary S. Dietrich
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Bob R. Stewart
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Jane M. Armer
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Sheila H. Ridner.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Ridner, S.H., Dietrich, M.S., Stewart, B.R. et al. Body mass index and breast cancer treatment-related lymphedema. Support Care Cancer 19, 853–857 (2011). https://doi.org/10.1007/s00520-011-1089-9

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00520-011-1089-9

Keywords

Search

Navigation