Table 4. Body mass index (BMI) as risk factor for arm morbidity following breast cancer treatments.
Disability | Author | N | Follow-up | Measure | Comparison/Comments | P-value | OR/RR/HR | CI (95%) | Type of evidence | Evidence level |
---|---|---|---|---|---|---|---|---|---|---|
Lymphedema | Deutsch 2008 [51] | 1,457 | Arm circumferences | 0.001 | RCT | 1B | ||||
Box 2002 [57] | 65 | 24 months | Arm circumferences, arm volume and multi-frequency bioimpedance | 0.01 | OR = 1.21 | 1.04–1.41 | RCT | 1B | ||
Nesvold 2008 [48] | 263 | 47 months | Volume calculation | <0.01 | OR = 1.11 | 1.04–1.19 | Prospective study | 2B | ||
Kwan 2010 [49] | 997 | 20.9 months | Examination by a specialist | BMI 25 (healthy weight) 25–29 (overweight) >30 (obese) | HR = 1.43 | 0.88–2.31 | Prospective study | 2B | ||
Zou 2018 [47] | 387 | 24 months | Circumference and Norman questionnaire | BMI <24/24< | 0.03 | HR = 1.1 | 1.0–1.1 | Prospective study | 2B | |
Shahpar 2013 [50] | 410 | 3 years | Arm circumferences | Increase of 1 kg/m2 in Body mass index | <0.001 | OR = 1.09 | 1.05–1.15 | Prospective cohort study | 2B | |
Das 2015 [55] | 199 | 2–15-year | Self-reported | BMI> = 25 treated with tamoxifen | 0.05 | OR = 2.62 | 0.99–6.93 | Prospective cohort | 2B | |
Mclaughlin 2008 [52] | 936 | 5 years | Circumference | <0.001 | Prospective study | 2B | ||||
Kilbreath 2016 [53] | 450 | 18-months | Bio-impedance spectroscopy | <5/>5 lymph nodes removed | 0.08 | OR = 1.9 | 0.9–3.9 | Prospective cohort | 2B | |
Kuijer 2021 [17] | 1,037 | 1-year | Self-reported | BMI 25–30 | 0.03 | OR = 1.7 | Prospective cohort study | 2B | ||
Bevilacqua 2012 [42] | 1,051 | 5 years | Arm circumference measurement | BMI <25/>25 | 0.001 | Prospective cohort | 2B | |||
Chan 2009 [41] | 5 years | Arm circumference measurement | 0.007 | OR = 1.11 | 1.03–1.21 | Matched case-control study | 3B | |||
Meeske 2009 [35] | 494 | 50 months after diagnosis | Self-report of lymphedema | OR for, BMI>30 = 2.48 | 1.05–5.84 | A case-control study | 4 | |||
Petrek 2001 [54] | 923 | 20 years | Circumferential arm measurements | 0.08 | Cross-sectional | 4 | ||||
Mccredie 2001 [56] | 809 | Self-reported | For BMI>30 | 0.02 | OR = 1.7 | 1.1–2.6 | Population-based study | 4 | ||
Smoot 2010 [104] | 144 | The DASH questionnaires and circumference measurement | 0.041 | −3.68–−0.08 | Cross-sectional study | 4 | ||||
Lymphedema BMI>25 | Nesvold 2008 [48] | 263 | 47 months | British Columbia Cancer Agency in Canada | <0.01 | OR = 1.12 | 1.04–1.19 | Prospective study | 2B | |
Dominick 2013 [61] | 2,431 | 6 years | Norman and colleagues’ validated telephone lymphedema questionnaire | For BMI>30 | <0.01 | OR = 2.08 | 1.66–2.60 | Prospective cohort study | 2B | |
Ugur 2013 [62] | 455 | 53 months | Tape measure | BMI <25/>25 | <0.001 | OR = 3.94 | 1.97–7.87 | Prospective study | 2B | |
Park 2008 [63] | 450 | 24 months | Tape measure | BMI <25/>25 | 0.023 | OR = 2.01 | 1.10–3.68 | Prospective study | 2B | |
Clark 2005 [64] | 251 | 3 years | Tape measure | BMI <25/>25 | RR = 2.02 | 1.11–3.68 | Prospective observational study | 2B | ||
Crosby 2012 [58] | 1,117 | From medical record | Immediate breast reconstruction and BMI <25/>25 | 0.008 | OR = 2.78 | 1.30–5.94 | Retrospective study | 4 | ||
Functional disabilities | Nesvold 2008 [48] | 263 | 47 months | British Columbia Cancer Agency in Canada | 0.001 | OR = 1.12 | 1.05–1.2 | Prospective study | 2B | |
Hack 2010 [59] | 316 | 12 months | The DASH Questionnaire | 0.026 | Cross-sectional study | 4 | ||||
Decreased range of motion | Kuijer 2021 [17] | 1,037 | 1-year | CARES-SF | For BMI 25–30 | 0.05 | OR = 1.5 | Multicenter prospective cohort study | 2B | |
Levy 2012 [40] | 115 | 12 months | Harvard Alumni Health Study Physical Activity Questionnaire | BMI <25/>25 | <0.05 | Prospective study | 2B | |||
Basu 2020 [60] | 342 | 37 months | Questionnaire was inspired by the Australian BC Family Study | BMI <25/>25 | 0.04 | HR = 1.42 | 1.6–2.4 | Retrospective study | 4 | |
Persistent pain | Laurence 2017 [65] | 0.008 | OR = 1.34 | 1.08–1.67 | Meta analysis | 1A | ||||
Sipilä 2012 [44] | 489 | 6 months | NPRS | BMI <25, 26–30, >30 | <0.01 | OR = 0.58 | 0.34–0.98 | Prospective study | 2B |
Abbreviations: N: number; CI: confidence interval; OR: odds ratio; HR: hazard ratio; RR: relative risk; BMI: body mass index; NPRS: numeric pain rating scale; RCT: randomize control trail.