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. 2023 Dec 1;14:921–942. doi: 10.18632/oncotarget.28539

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.