Cellulitis and breast cancer-related lymphedema: risk factors and timing
Havens, Lauren Michael
MetadataShow full item record
PURPOSE: This study investigated the risk factors for cellulitis infection, the median time to onset of low volume swelling (5 to 10% relative volume change (RVC) and breast cancer-related lymphedema (BCRL) (≥10% RVC) after an incidence of cellulitis, and the impact of common risk factors of both cellulitis and lymphedema on low volume swelling and BCRL. METHODS: We reviewed electronic medical records of 98 patients who underwent unilateral breast cancer (BC) surgery in the year 2011, who had a presurgical baseline perometry measurement and at least two postsurgical follow-up measurements. Clinicopathologic data, edema, and cellulitis incidence were obtained by medical record review. RESULTS: 18.37% of patients (18/98) experienced at least one incidence of cellulitis at a median of 1.03 years postoperatively. Of those 18 patients, 44.44% (eight out of 18) developed low volume swelling and 11.11% (two out of 18) developed BCRL at a median of 1.08 years and 2.33 years postoperatively, respectively. The median time to cellulitis incidence was 0.94 years and 2.91 years after the onset of low volume swelling and BCLR, respectively. Univariate logistic regression revealed that regional lymph node radiation (RLNR) (OR 4.4; p = 0.032) and low volume swelling (OR 6.56; p = 0.004) are significant risk factors for BCRL. RLNR remained a significant risk factor for the development of BCRL by multivariate logistic regression (OR 9.43; p = 0.031). CONCLUSION: Cellulitis may not incite or worsen pre-existing BCRL or affect the median time to BCRL development. However, lymphedema may put patients at risk of cellulitis infection. Sample size may have precluded statistical significance and further research is required to definitively identify the effect of cellulitis infection on lymphedema risk.
RightsAttribution 4.0 International