RISK FACTORS FOR LYMPHEDEMA IN BREAST CANCER SURVIVORS Mary Anne Rossing, Ph.D., Kathleen E. Malone, Ph.D., and Mei-Tzu C. Tang, Ph.D. Fred Hutchinson Cancer Research Center, Seattle, WA E-mail: mrossing@fhcrc.org Lymphedema of the arm is a common, yet dreaded consequence of breast cancer treatment that can result in substantial functional impairment and distress. While axillary surgery and radiation treatment are known risk factors for lymphedema, few other characteristics that may influence risk have been studied. Through this research, we will assess whether modifiable factors, including body weight, physical activity, smoking, and breast reconstruction, influence risk of arm lymphedema. We are conducting a prospective study in a cohort of women aged 21-74 years diagnosed with a first primary invasive breast cancer from October 2002 to July 2004. Eligible women have undergone axillary dissection as part of their cancer treatment, and are identified through a population-based cancer registry in Washington State. The occurrence of lymphedema is assessed using physical measures and self-report at regular intervals throughout this four-year study. Arm circumference is measured at 1.5-inch intervals from hand to axilla, and these measures are converted to arm volume. Each time they undergo arm measurement, women also complete interviews detailing and updating information on the exposures of interest and potential confounding factors. Results: presented here are based on the baseline questionnaires and measurements of the first 256 women enrolled in the study. Women were enrolled 5-22 months after their initial breast cancer diagnosis (median, 10 months), and 0-21 months after their axillary lymph node surgery (median, 9 months). Five women who had had bilateral breast cancer and axillary dissection and 1 woman who declined measurement were excluded from subsequent analyses. At interview, 93 women (37.2%) reported that they had experienced swelling of the surgery-side arm for two weeks or longer, and 84 reported current swelling. For 42 women (16.8%), the calculated volume of the surgery-side arm was > 200 ml larger than the contralateral arm. This included 15 (9.2%) of the women who reported no current swelling and 27 (32.1%) of the women who reported current swelling. Increasing body mass was associated with lymphedema defined either by self-report or by calculated arm volume. Relative to women with a body mass index (BMI) < 25, the odds ratios and 95% confidence intervals for lymphedema based upon self-report and arm measurement, respectively, among women with a BMI > 30 were 2.5 (1.2-4.8) and 6.1 (2.4-15.5). Future analyses in this study cohort will assess changes in arm volume over time and relationships with treatment and lifestyle factors. As increasing numbers of women with breast cancer survive their illness, identifying evidence-based strategies to minimize the long-term consequences of treatment, such as lymphedema, is increasingly important. Abstract ERA 2005 Remember we are NOT Doctors and have NO medical training. This site is like an Encylopedia - there are many pages, many links on many topics. Support our work with any size DONATION - see left side of any page - for how to donate. You can help raise awareness of CAM.