Table 2b.
Hazard ratios (HRs) of breast cancer-related lymphedema (BCRL) following surgery in association with clinical features, by follow-up length, among women with breast cancer (stage I-III) in the Carolina Breast Cancer Study (Phase 3, diagnosis years 2008-2013)
| Clinical features | Total participants (n with BCRL) | Crude 5-y risk of BCRL, % (95% confidence interval) | HR (95% confidence interval)a | ||
|---|---|---|---|---|---|
| FU ≤ 7 months | FU > 7 months | ||||
| Hypertension | No | 1508 (300) | 21.9 (19.6, 24.1) | 1 | 1 |
| Yes | 1137 (252) | 24.3 (21.6, 26.9) | 1.06 (0.82, 1.37) | 1.19 (0.96, 1.48) | |
| Diabetes | No | 2268 (472) | 22.9 (21.0, 24.7) | 1 | 1 |
| Yes | 377 (80) | 23.1 (18.5, 27.7) | 1.30 (0.93, 1.83) | 0.83 (0.59, 1.16) | |
| Lymph node status | Negative | 1657 (224) | 14.3 (12.6, 16.1) | 1 | 1 |
| Positive | 986 (328) | 38.6 (35.2, 42.0) | 2.17 (1.67, 2.81) | 3.50 (2.80, 4.38) | |
| Tumor size | ≤5cm | 2368 (472) | 21.6 (19.9, 23.4) | 1 | 1 |
| >5 cm | 271 (77) | 36.5 (29.6, 43.4) | 0.97 (0.64, 1.48) | 2.28 (1.69, 3.07) | |
| Histologic grade (differentiation) | Well/Moderate | 671 (125) | 20.1 (16.9, 23.4) | 1 | 1 |
| Poor | 1826 (401) | 24.3 (22.2, 26.4) | 0.95 (0.71, 1.27) | 1.23 (0.94, 1.60) | |
| ER status | Positive/Borderline | 1954 (378) | 21.1 (19.2, 23.1) | 1 | 1 |
| Negative | 682 (171) | 28.2 (24.5, 31.9) | 0.90 (0.67, 1.21) | 1.56 (1.24, 1.97) | |
| BMI, kg/m2 | ≤25 | 657 (89) | 14.8 (11.9, 17.8) | 1 | 1 |
| 25-29 | 736 (135) | 20.4 (17.2, 23.5) | 1.71 (1.11, 2.63) | 1.17 (0.83, 1.66) | |
| 30+ | 1241 (327) | 29.0 (26.3, 31.7) | 2.17 (1.47, 3.20) | 1.82 (1.35, 2.45) | |
| Number of lymph nodes removed | ≤5 | 1510 (184) | 12.9 (11.1, 14.7) | 1 | 1 |
| >5 | 1129(366) | 37.1 (34.0, 40.3) | 2.65 (1.99, 3.53) | 1.92 (1.53, 2.41) | |
| Surgery type | Local excision | 1413 (251) | 18.8 (16.7, 21.0) | 1 | 1 |
| Mastectomy | 1232 (301) | 28.0 (25.2, 30.7) | 1.46 (1.20, 1.91) | 1.17 (0.93, 1.47) | |
| Chemotherapy | No | 967 (97) | 10.7 (8.6, 12.7) | 1 | 1 |
| Yes | 1678 (455) | 30.3 (27.9, 32.7) | 1.79 (1.29, 2.47) | 2.24 (1.68, 2.99) | |
| Radiation therapy | No | 725 (117) | 18.2 (15.2, 21.2) | 1 | 1 |
| Yes | 1920 (435) | 24.7 (22.6, 26.7) | 0.88 (0.65, 1.17) | 1.48 (1.10, 2.00) | |
| Treated on dominant side | No | 1318 (286) | 23.4 (20.1, 25.8) | 1 | 1 |
| Yes | 1325 (266) | 22.4 (20.0, 24.9) | 0.84 (0.65, 1.09) | 0.96 (0.77, 1.19) | |
a.
All models were adjusted for age and race. Models for surgery type, number of lymph nodes removed, chemotherapy, radiotherapy were additionally adjusted for tumor characteristics (i.e., tumor size, lymph node status, histologic grade, and ER status).