Xiping Zhang1, Binbin Tang2,*, Dehong Zou1,*, Hongjian Yang1, Enqi Qiao1, Xiangming He1 and Feijiang Yu3. Bioscience Reports (2019) 39

Main findings

• The risk of lymphedema was 1.7 times higher among patients with breast cancer and lymph node metastasis than those without lymph node metastasis and proportional to the number of metastatic lymph nodes. The incidence of lymphedema was 1.78 times higher among patients with 10 or more metastatic lymph nodes than others with 3 or fewer metastatic lymph nodes, and 2.17 times higher than others without lymph node metastasis.
• The pathological type of breast cancer was another factor that impacted BCRL. Compared with patients with ductal carcinoma in situ, the incidence of lymphedema was 2.4 times higher among those within filtrating ductal carcinoma, and pathological molecular subtypes of breast cancer were insignificantly correlated to the genesis of BCRL.
• The genesis of BCRL was related to T stage of breast cancer, lymph node metastasis, the number of metastatic lymph nodes, pTNM stage, and pathological types of tumors, perhaps because normal functions of the lymphatic system were heavily impaired in patients with infiltrating ductal carcinoma or lymph node metastasis or patients at the advanced pTNM stage, and lymphatic reflux was blocked owing to their more severe lymph node metastasis.
• The extent of surgical resection was usually wider among this type of patients. Before and after operations, more adjuvant therapies like radiotherapies were needed. All these factors would aggravate damages to the lymphatic system and its peripheral tissues.