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Journal of the Korean Academy of Rehabilitation Medicine 2008;32(1):95-99.
Risk Factors for Developing Upper Limb Lymphedema following Breast Cancer Surgery.
Jeong, Ho Joong , Eom, Moon Sub , Choi, Sung Bock , Kim, Do Sung , Kang, Kyung Moon
Department of Physical Medicine and Rehabilitation, Kosin University College of Medicine, Seoul, Korea. drbocks@freechal.com
유방암 수술 후 상지 림프부종 발생의 위험인자
정호중, 엄문섭, 최성복, 김도성, 강경문
고신대학교 의과대학 재활의학교실
Abstract
Objective
To identify the risk factors for secondary lymphedema after breast cancer surgery. Lymphedema, a sequelae of breast cancer therapy, changes functional abilities and may affect a patient's psychosocial adjustment and overall quality of life. It is generally underreported and undertreated.
Method
Six hundred two patients who had undergone breast cancer surgery between January 2000 and December 2005 were examined. The circumferences of the upper extremities were measured and lymphedema was defined as difference of greater than 2cm between the affected and normal arms. The effects of age, body mass index, diabetes, hypertension, side of tumor, sugery method, radiotherapy, chemotherapy, TNM stage, involvement of axillary lymph nodes, menopausal state and laboratory findings on the development lymphedema were investigated and analyzed by t-test, chi-square test and multiple logistic regression analysis.
Results
121 out of 602 patients had lymphedema. Those patients with lymphedema had a higher body mass index. Univariate analysis indicated an increased occurrence of lymphedema due to those with body mass index, radiotherapy, T2 stage, N3 stage and axillary lymph node invasion. Multivariate analysis revealed that body mass index and radiotherapy were independently associated factors for lymphedema after breast cancer surgery.
Conclusion
The patients who had radiotherapy or BMI greater than 25 must be considered as potential candidates to have lymphedema after breast cancer surgery. Therefore, these patients should be informed during the follow-up period about this morbidity, the preventive measure, and the treatment. (J Korean Acad Rehab Med 2008; 32: 95-99)
Key Words: Risk factor, Lymphedema, Breast cancer


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