Annali italiani di chirurgia · 2025
Analysis of the Influencing Factors of Postoperative Lymphedema of Breast Cancer and the Influence of Axillary Reverse Mapping on Edema and Postoperative Quality of Life.
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Zeng HuanLi, Wang Xiu, Xiao Yi, Xie ShangYu, Zhuang ChuanRen
Аннотация
AIM: Postoperative lymphedema was a common and debilitating complication following breast cancer surgery, which significantly affects quality of life. This study analyzes the risk factors associated with lymphedema and evaluates the effectiveness of axillary reverse mapping (ARM) in reducing its incidence and improving quality of life.
METHODS: For this retrospective cohort study, 232 breast cancer patients who underwent axillary dissection between January 2022 and January 2023 were recruited. Patients were classified into the lymphedema group (n = 54) and the control group (n = 178) based on edema occurrence. Influencing factors such as body mass index, surgical techniques, and adjuvant therapies were analyzed. To assess ARM's impact on lymphedema and quality of life, patients were also divided into a mapping group (n =133) and the control group (n = 99). Lymphedema stages were evaluated according to the International Lymphatic Society consensus, and quality of life was assessed using the Quality of Working Life Questionnaire for Cancer Survivors (QWLQ-CS), Breast Cancer Survivors Resilience Scale (BCRS), and Strategies Used by People to Promote Health (SUPPH) scale.
RESULTS: The results showed that chemotherapy (odds ratios [OR]: 4.063; p < 0.001) and radiotherapy (OR: 3.358; p < 0.001) were significant risk factors for lymphedema. ARM was associated with a reduced risk of lymphedema (OR: 0.322, p = 0.004). A higher proportion of patients in the mapping group were classified as having Stage 0 lymphedema (86.46%) compared to the control group (63.67%). For the mapping group, the QWLQ-CS was 71.04 ± 12.31 (p = 0.041), BCRS was 23.89 ± 6.32 (p = 0.003), and SUPPH was 85.65 ± 12.57 (p = 0.001), which were significantly higher than the control group.
CONCLUSIONS: Postoperative lymphedema risk in breast cancer patients is influenced by chemotherapy and radiotherapy, with ARM proving beneficial in reducing incidence and enhancing postoperative quality of life.
METHODS: For this retrospective cohort study, 232 breast cancer patients who underwent axillary dissection between January 2022 and January 2023 were recruited. Patients were classified into the lymphedema group (n = 54) and the control group (n = 178) based on edema occurrence. Influencing factors such as body mass index, surgical techniques, and adjuvant therapies were analyzed. To assess ARM's impact on lymphedema and quality of life, patients were also divided into a mapping group (n =133) and the control group (n = 99). Lymphedema stages were evaluated according to the International Lymphatic Society consensus, and quality of life was assessed using the Quality of Working Life Questionnaire for Cancer Survivors (QWLQ-CS), Breast Cancer Survivors Resilience Scale (BCRS), and Strategies Used by People to Promote Health (SUPPH) scale.
RESULTS: The results showed that chemotherapy (odds ratios [OR]: 4.063; p < 0.001) and radiotherapy (OR: 3.358; p < 0.001) were significant risk factors for lymphedema. ARM was associated with a reduced risk of lymphedema (OR: 0.322, p = 0.004). A higher proportion of patients in the mapping group were classified as having Stage 0 lymphedema (86.46%) compared to the control group (63.67%). For the mapping group, the QWLQ-CS was 71.04 ± 12.31 (p = 0.041), BCRS was 23.89 ± 6.32 (p = 0.003), and SUPPH was 85.65 ± 12.57 (p = 0.001), which were significantly higher than the control group.
CONCLUSIONS: Postoperative lymphedema risk in breast cancer patients is influenced by chemotherapy and radiotherapy, with ARM proving beneficial in reducing incidence and enhancing postoperative quality of life.