Upper Limb Lymphedema Impacts the Risk of Peripherally Inserted Central Catheter-Related Thrombosis in Patients with Breast Cancer.

Abstract

There is little information on the risk for catheter-related thrombosis in patients with upper limb lymphedema following breast cancer treatment. We investigated the association between upper limb lymphedema and the risk of peripherally inserted central catheterrelated thrombosis (PICC-RT) occurring in the contralateral limb of patients with breast cancer. A retrospective review analyzed all patients with breast cancer who underwent PICC insertion at a cancer hospital in Hunan Province from 2015 to 2019. Upper limb lymphedema was indexed from hospital information system (HIS) before the occurrence of PICC-RT developed in the contralateral limb. Cox regression analysis was used to evaluate the association of factors with outcome. A total of 1,262 patient records were found and 50 cases of PICC-RT were identified. Forty of these occurred in patients without lymphedema (n=1,236) and 10 in patients with upper limb lymphedema (n=26). After adjustment for various co-variables, Cox regression analysis showed that upper limb lymphedema was significantly associated with increased risk of PICC-RT (hazard ratio=12.128, 95% confidence interval=5.551-26.501; P<0.001). In breast cancer patients, upper limb lymphedema may be an important predictor for PICC-RT in the contralateral limb and information should be provided to patients.