Assessment of potential risk factors and skin ultrasound presentation associated with breast cancer-related lymphedema in long-term breast cancer survivors
Breast cancer has been reported to have the highest survival rate among various cancers. However, breast cancer survivors face several challenges following breast cancer treatment including breast cancer-related lymphedema (BCRL), sexual dysfunction, and psychological distress. This study aimed to i...
| Main Authors: | , , , , , , , , , |
|---|---|
| Format: | Article |
| Published: |
Multidisciplinary Digital Publishing Institute
2021
|
| Online Access: | http://psasir.upm.edu.my/id/eprint/96089/ |
| _version_ | 1848862293089058816 |
|---|---|
| author | Md Yusof, Khairunnisa’ Avery-Kiejda, Kelly A. Ahmad Suhaimi, Shafinah Ahmad Zamri, Najwa Rusli, Muhammad Ehsan Fitri Mahmud, Rozi Mohd Saini, Suraini Ibraheem, Shahad Abdul Wahhab Abdullah, Maha Rosli, Rozita |
| author_facet | Md Yusof, Khairunnisa’ Avery-Kiejda, Kelly A. Ahmad Suhaimi, Shafinah Ahmad Zamri, Najwa Rusli, Muhammad Ehsan Fitri Mahmud, Rozi Mohd Saini, Suraini Ibraheem, Shahad Abdul Wahhab Abdullah, Maha Rosli, Rozita |
| author_sort | Md Yusof, Khairunnisa’ |
| building | UPM Institutional Repository |
| collection | Online Access |
| description | Breast cancer has been reported to have the highest survival rate among various cancers. However, breast cancer survivors face several challenges following breast cancer treatment including breast cancer-related lymphedema (BCRL), sexual dysfunction, and psychological distress. This study aimed to investigate the potential risk factors of BCRL in long term breast cancer survivors. A total of 160 female breast cancer subjects were recruited on a voluntary basis and arm lymphedema was assessed through self-reporting of diagnosis, arm circumference measurement, and ultrasound examination. A total of 33/160 or 20.5% of the women developed BCRL with significantly higher scores for upper extremity disability (37.14 ± 18.90 vs. 20.08 ± 15.29, p < 0.001) and a lower score for quality of life (103.91 ± 21.80 vs. 115.49 ± 16.80, p = 0.009) as compared to non-lymphedema cases. Univariate analysis revealed that multiple surgeries (OR = 5.70, 95% CI: 1.21–26.8, p < 0.001), axillary lymph nodes excision (>10) (OR = 2.83, 95% CI: 0.94–8.11, p = 0.047), being overweight (≥25 kg/m2) (OR = 2.57, 95% CI: 1.04 – 6.38, p = 0.036), received fewer post-surgery rehabilitation treatment (OR = 2.37, 95% CI: 1.05–5.39, p = 0.036) and hypertension (OR = 2.38, 95% CI: 1.01–5.62, p = 0.043) were associated with an increased risk of BCRL. Meanwhile, multivariate analysis showed that multiple surgeries remained significant and elevated the likelihood of BCRL (OR = 5.83, 95% CI: 1.14–29.78, p = 0.034). Arm swelling was more prominent in the forearm area demonstrated by the highest difference of arm circumference measurement when compared to the upper arm (2.07 ± 2.48 vs. 1.34 ± 1.91 cm, p < 0.001). The total of skinfold thickness of the affected forearm was also significantly higher than the unaffected arms (p < 0.05) as evidenced by the ultrasound examination. The continuous search for risk factors in specific populations may facilitate the development of a standardized method to reduce the occurrence of BCRL and provide better management for breast cancer patients. |
| first_indexed | 2025-11-15T13:14:43Z |
| format | Article |
| id | upm-96089 |
| institution | Universiti Putra Malaysia |
| institution_category | Local University |
| last_indexed | 2025-11-15T13:14:43Z |
| publishDate | 2021 |
| publisher | Multidisciplinary Digital Publishing Institute |
| recordtype | eprints |
| repository_type | Digital Repository |
| spelling | upm-960892023-02-23T03:28:35Z http://psasir.upm.edu.my/id/eprint/96089/ Assessment of potential risk factors and skin ultrasound presentation associated with breast cancer-related lymphedema in long-term breast cancer survivors Md Yusof, Khairunnisa’ Avery-Kiejda, Kelly A. Ahmad Suhaimi, Shafinah Ahmad Zamri, Najwa Rusli, Muhammad Ehsan Fitri Mahmud, Rozi Mohd Saini, Suraini Ibraheem, Shahad Abdul Wahhab Abdullah, Maha Rosli, Rozita Breast cancer has been reported to have the highest survival rate among various cancers. However, breast cancer survivors face several challenges following breast cancer treatment including breast cancer-related lymphedema (BCRL), sexual dysfunction, and psychological distress. This study aimed to investigate the potential risk factors of BCRL in long term breast cancer survivors. A total of 160 female breast cancer subjects were recruited on a voluntary basis and arm lymphedema was assessed through self-reporting of diagnosis, arm circumference measurement, and ultrasound examination. A total of 33/160 or 20.5% of the women developed BCRL with significantly higher scores for upper extremity disability (37.14 ± 18.90 vs. 20.08 ± 15.29, p < 0.001) and a lower score for quality of life (103.91 ± 21.80 vs. 115.49 ± 16.80, p = 0.009) as compared to non-lymphedema cases. Univariate analysis revealed that multiple surgeries (OR = 5.70, 95% CI: 1.21–26.8, p < 0.001), axillary lymph nodes excision (>10) (OR = 2.83, 95% CI: 0.94–8.11, p = 0.047), being overweight (≥25 kg/m2) (OR = 2.57, 95% CI: 1.04 – 6.38, p = 0.036), received fewer post-surgery rehabilitation treatment (OR = 2.37, 95% CI: 1.05–5.39, p = 0.036) and hypertension (OR = 2.38, 95% CI: 1.01–5.62, p = 0.043) were associated with an increased risk of BCRL. Meanwhile, multivariate analysis showed that multiple surgeries remained significant and elevated the likelihood of BCRL (OR = 5.83, 95% CI: 1.14–29.78, p = 0.034). Arm swelling was more prominent in the forearm area demonstrated by the highest difference of arm circumference measurement when compared to the upper arm (2.07 ± 2.48 vs. 1.34 ± 1.91 cm, p < 0.001). The total of skinfold thickness of the affected forearm was also significantly higher than the unaffected arms (p < 0.05) as evidenced by the ultrasound examination. The continuous search for risk factors in specific populations may facilitate the development of a standardized method to reduce the occurrence of BCRL and provide better management for breast cancer patients. Multidisciplinary Digital Publishing Institute 2021 Article PeerReviewed Md Yusof, Khairunnisa’ and Avery-Kiejda, Kelly A. and Ahmad Suhaimi, Shafinah and Ahmad Zamri, Najwa and Rusli, Muhammad Ehsan Fitri and Mahmud, Rozi and Mohd Saini, Suraini and Ibraheem, Shahad Abdul Wahhab and Abdullah, Maha and Rosli, Rozita (2021) Assessment of potential risk factors and skin ultrasound presentation associated with breast cancer-related lymphedema in long-term breast cancer survivors. Diagnostics, 11 (8). art. no. 1303. pp. 1-21. ISSN 2075-4418 https://www.mdpi.com/2075-4418/11/8/1303 10.3390/diagnostics11081303 |
| spellingShingle | Md Yusof, Khairunnisa’ Avery-Kiejda, Kelly A. Ahmad Suhaimi, Shafinah Ahmad Zamri, Najwa Rusli, Muhammad Ehsan Fitri Mahmud, Rozi Mohd Saini, Suraini Ibraheem, Shahad Abdul Wahhab Abdullah, Maha Rosli, Rozita Assessment of potential risk factors and skin ultrasound presentation associated with breast cancer-related lymphedema in long-term breast cancer survivors |
| title | Assessment of potential risk factors and skin ultrasound presentation associated with breast cancer-related lymphedema in long-term breast cancer survivors |
| title_full | Assessment of potential risk factors and skin ultrasound presentation associated with breast cancer-related lymphedema in long-term breast cancer survivors |
| title_fullStr | Assessment of potential risk factors and skin ultrasound presentation associated with breast cancer-related lymphedema in long-term breast cancer survivors |
| title_full_unstemmed | Assessment of potential risk factors and skin ultrasound presentation associated with breast cancer-related lymphedema in long-term breast cancer survivors |
| title_short | Assessment of potential risk factors and skin ultrasound presentation associated with breast cancer-related lymphedema in long-term breast cancer survivors |
| title_sort | assessment of potential risk factors and skin ultrasound presentation associated with breast cancer-related lymphedema in long-term breast cancer survivors |
| url | http://psasir.upm.edu.my/id/eprint/96089/ http://psasir.upm.edu.my/id/eprint/96089/ http://psasir.upm.edu.my/id/eprint/96089/ |