Breast cancer-related lymphoedema: risk factors and prediction model
Author
Armora Verdú, Miriam
Garcia Forero, Carlos
Álvarez Salazar, Samantha
Masia, Jaume
Publication date
2021ISSN
0309-2402
Abstract
Aims: To identify the risk factors for lymphoedema following axillary lymph node dissection (ALND) in a European sample and to propose a lymphoedema prediction model for this population. Design: Predictive retrospective cohort study comparing women who developed lymphoedema in 2 years of undergoing ALND with those who did not developed lymphoedema. Methods: We reviewed the clinical records of 504 women who, between January 2008 and May 2018, underwent surgery for breast cancer that involved ALND. Logistic regression was used to identify significant risk factors for lymphoedema. The prediction accuracy of the model was assessed by calculating the area under the receiver operating characteristic curve. Results: Of the 504 women whose records were analysed, 156 developed lymphoedema. Significant predictors identified in the regression model were level of lymph node dissection, lymph node status, post-operative complications, body mass index (BMI) and number of lymph nodes extracted. The prediction model showed good sensitivity (80%) in the study population. Conclusions: The factor contributing most to the risk of lymphoedema was the level of lymph node dissection, and the only patient-related factor in the prediction model was BMI. The model offers good predictive capacity in this population and it is a simple tool that breast care units could use to assess the risk of lymphoedema following ALND. Nurses with specialist knowledge of lymphoedema have a key role to play in ensuring that women receive holistic and individualized care. Impact: What problem did the study address? Secondary lymphoedema is one of the main complications in the treatment of breast cancer. What were the main findings? The prediction model included five factors associated with the risk of lymphoedema following ALND. The strongest predictor was the level of lymph node dissection, and the only patient-related factor was BMI. Where and on whom will the research have an impact? The prediction model offers breast care units a tool for assessing the risk of lymphoedema in women undergoing surgery involving ALND. The results highlight the importance of weight reduction as a preventive measure and support a more conservative surgical approach.
Document Type
Article
Document version
Published version
Language
English
Subject (CDU)
616 - Pathology. Clinical medicine
Keywords
Dissecció de ganglis limfàtics axil·lars
Càncer de mama
Limfedema relacionat amb el càncer de mama
Infermeres
Infermeria
Model de predicció
Estudi predictiu
Factors de risc
Corba ROC
Limfedema secundari
Disección ganglionar axilar
Cáncer de mama
Linfedema relacionado con cáncer de mama
Enfermeras
Enfermería
Modelo de predicción
Modelo de predicción
Factores de riesgo
Curva ROC
Linfedema secundario
Axillary lymph node dissection
Breast cancer
Breast cancer-related lymphoedema
Nurses
Nursing
Prediction model
Predictive study
Risk factors
ROC curve
Secondary lymphoedema
Pages
10
Publisher
Wiley
Collection
78; 3
Is part of
Journal of Advanced Nursing
Citation
Martínez-Jaimez, Patricia; Armora Verdú, Miriam; Garcia Forero, Carlos [et al]. Breast cancer-related lymphoedema: risk factors and prediction model. Journal of Advanced Nursing, 2021, 78(3), p. 765-775. Disponible en: <https://onlinelibrary.wiley.com/doi/10.1111/jan.15005>. Fecha de acceso: 11 mar. 2024. DOI: 10.1111/jan.15005
This item appears in the following Collection(s)
- Ciències de la Salut [738]
Rights
© 2021 John Wiley & Sons Ltd.