Multimodal treatments and the risk of breast cancer-related lymphedema: insights from a nationally representative cohort in South Korea.

IF 3.4 2区医学 Q2 ONCOLOGY BMC Cancer Pub Date : 2025-01-22 DOI:10.1186/s12885-025-13513-5

Sung Hoon Jeong, Seong Min Chun, Miji Kim, Ye Seol Lee, Jisun Kim, Ja-Ho Leigh, Yoon-Hee Choi

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Abstract

Background: As the roles of chemotherapy (Chemo) and radiation therapy (Radio) in the definitive treatment of breast cancer have expanded, a broader understanding of the factors associated with breast cancer-related lymphedema (BCRL) has become increasingly essential. Therefore, we investigated the association between multimodality treatment and the risk of BCRL.

Methods: In this retrospective study conducted using National Health Insurance data and the Korea National Cancer Incidence Database (2006-2017), 114,638 participants who underwent Surgery (Surg) or Chemo within 6 months after breast cancer diagnosis were enrolled, and the effect of multimodality treatment on the risk of BCRL was analyzed using the Cox proportional-hazards model. Multimodality treatment administered through six months of treatment was grouped as only Surg; Surg/Chemo; Surg/ Chemo/Radio; Surg/Radio; only Chemo; and Chemo/Radio.

Results: The risk of BCRL was higher in the Surg/Chemo group (hazard ratio [HR]: 1.54, 95% confidence interval [CI]: 1.43-1.65), Surg/Chemo/Radio group (HR: 1.51, 95% CI: 1.43-1.65), only Chemo group (HR: 1.58, 95% CI: 1.45-1.71), and Chemo/Radio group (HR: 1.13, 95% CI: 1.00-1.29) in comparison with the only Surg group.

Conclusion: BCRL occurrence is an after-effect of complex breast cancer treatments, and the risk may vary depending on the treatment method, including Surg, chemo, and radio. Our findings suggest that multidisciplinary strategies are required to minimize the risk of BCRL development in patients with breast cancer.

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多模式治疗和乳腺癌相关淋巴水肿的风险：来自韩国全国代表性队列的见解。

背景：随着化疗（Chemo）和放射治疗（Radio）在乳腺癌最终治疗中的作用不断扩大，对乳腺癌相关性淋巴水肿（BCRL）相关因素的更广泛理解变得越来越重要。因此，我们调查了多模式治疗与BCRL风险之间的关系。方法：本回顾性研究采用国民健康保险数据和韩国国家癌症发病率数据库（2006-2017），纳入114,638名乳腺癌诊断后6个月内接受手术或化疗的参与者，使用Cox比例风险模型分析多模式治疗对BCRL风险的影响。通过6个月的治疗进行多模式治疗分为仅手术；杂志/化疗;杂志/化学/广播;杂志/广播;只有化疗;和化疗/收音机。结果：与仅手术组相比，手术/化疗组（风险比[HR]: 1.54, 95%可信区间[CI]: 1.43-1.65）、手术/化疗/放疗组（风险比：1.51,95% CI: 1.43-1.65）、仅化疗组（风险比：1.58,95% CI: 1.45-1.71）和化疗/放疗组（风险比：1.13,95% CI: 1.00-1.29）发生BCRL的风险更高。结论：BCRL的发生是复杂乳腺癌治疗的后遗症，其发生风险随治疗方式的不同而不同，包括手术、化疗和放疗。我们的研究结果表明，需要多学科的策略来降低乳腺癌患者发生BCRL的风险。

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来源期刊

BMC Cancer 医学-肿瘤学

CiteScore

6.00

自引率

2.60%

发文量

1204

审稿时长

6.8 months

期刊介绍： BMC Cancer is an open access, peer-reviewed journal that considers articles on all aspects of cancer research, including the pathophysiology, prevention, diagnosis and treatment of cancers. The journal welcomes submissions concerning molecular and cellular biology, genetics, epidemiology, and clinical trials.