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ORIGINAL RESEARCH article

Front. Oncol.
Sec. Breast Cancer
Volume 14 - 2024 | doi: 10.3389/fonc.2024.1436748

Factors affecting lymphedema after neoadjuvant chemotherapy and axillary dissection in female breast cancer patients: A retrospective cohort study based on the Chinese population

Provisionally accepted
Yanjuan Lin Yanjuan Lin 1,2*Chuan Wang Chuan Wang 1,3,4,5*Jie Zhang Jie Zhang 1,3,4,5*Jianqin Fu Jianqin Fu 1,3,5Ruiliang Chen Ruiliang Chen 1,3,4,5Lijuan He Lijuan He 1,3,5*Liqun Bao Liqun Bao 1,3,5*Zhaodi Lin Zhaodi Lin 1,3,5*Weijing Jiang Weijing Jiang 1,3,5*
  • 1 Fujian Medical University Union Hospital, Fuzhou, China
  • 2 Department of Nursing, Fujian Medical University Union Hospital, fujian, China
  • 3 Other, Fuzhou, China
  • 4 Department of General Surgery, Union Hospital, Fujian Medical University, Fuzhou, Fujian Province, China
  • 5 Department of Breast Surgery, Affiliated Union Hospital of Fujian Medical University, Fuzhou, Fujian Province, China

The final, formatted version of the article will be published soon.

    ABSTRACT Purpose Breast cancer-related lymphedema (BCRL) is a common complication among breast cancer survivors. Most BCRL studies have focused on patients receiving adjuvant chemotherapy, with relatively little attention paid to BCRL in patients undergoing neoadjuvant chemotherapy (NAC). This study aimed to investigate the risk factors associated with BCRL in Chinese women undergoing NAC and axillary lymph node dissection (ALND). Methods At our institution, this cohort study collected data from 336 women with breast cancer and documented axillary nodal metastasis at diagnosis, who received NAC and ALND surgery between 2015 and 2020. BCRL was assessed through both objective limb circumference measurements and subjective self-reported symptoms. Multivariate logistic regression was employed to identify risk factors for BCRL, considering clinical, demographic, and lifestyle-related characteristics. Results The cumulative incidence of BCRL within 2.5 years was 43.75%. Factors independently associated with BCRL included radiotherapy (versus no radiotherapy; hazard ratio (HR) = 1.611; P = 0.020), NAC duration of 105 days or shorter (versus 105-143 days; HR = 0.471; P = 0.020), removal of more than 15 lymph nodes (versus 15 or fewer lymph nodes; HR = 1.593; P = 0.036), drainage duration of 20-29 days (versus 10-19 days; HR = 1.568; P = 0.028), and sleeping biased toward the affected arm (versus sleeping biased toward the healthy arm; HR = 2.033; P = 0.019). Conclusion This study identified several risk factors for BCRL in breast cancer patients following NAC and ALND. Patients presenting with one or more of these factors should be monitored closely for early detection and intervention. Further research is warranted to explore the impact of drainage duration and sleep position on the development of BCRL.

    Keywords: breast cancer, Lymphedema, Risk factors, ALND, Neoadjuvant chemotherapy

    Received: 22 May 2024; Accepted: 08 Oct 2024.

    Copyright: © 2024 Lin, Wang, Zhang, Fu, Chen, He, Bao, Lin and Jiang. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence:
    Yanjuan Lin, Fujian Medical University Union Hospital, Fuzhou, China
    Chuan Wang, Fujian Medical University Union Hospital, Fuzhou, China
    Jie Zhang, Fujian Medical University Union Hospital, Fuzhou, China
    Lijuan He, Fujian Medical University Union Hospital, Fuzhou, China
    Liqun Bao, Fujian Medical University Union Hospital, Fuzhou, China
    Zhaodi Lin, Fujian Medical University Union Hospital, Fuzhou, China
    Weijing Jiang, Fujian Medical University Union Hospital, Fuzhou, China

    Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.