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Table 1 Participant characteristics and their associations with lymphedema among 666 female breast cancer survivors

From: Risk factors for self-reported arm lymphedema among female breast cancer survivors: a prospective cohort study

Characteristics

Categories

N at risk

LE (%)

HR (95% CI)a

HR (95% CI)b

Breast cancer and treatment

     

Age at diagnosis (years)

35-44

123

43 (35.0)

1.00

1.00

45-49

128

43 (33.6)

0.98 (0.64 - 1.50)

0.98 (0.63 - 1.52)

50-54

175

46 (26.3)

0.80 (0.52 - 1.21)

0.79 (0.51 - 1.23)

55-59

128

35 (27.3)

0.83 (0.53 - 1.30)

0.78 (0.49 - 1.23)

60-64

112

23 (20.5)

0.59 (0.35 - 0.97)

0.61 (0.35 - 1.06)

Per unit of age

  

0.98 (0.96 - 1.00)

0.98 (0.96 - 1.00)

   

P trend = 0.03

P trend = 0.04

Disease stage

In situ

155

15 (9.7)

0.26 (0.15 - 0.45)

 

Localized

346

105 (30.4)

1.00

 

Regional

165

70 (42.4)

1.35 (0.99 - 1.85)

 

Tumor size (mm)

<10

178

36 (20.2)

1.00

 

10-19

216

66 (30.6)

1.54 (1.02 - 2.32)

 

20+

208

76 (36.5)

1.85 (1.23 - 2.77)

 

Missing

64

12 (18.8)

0.80 (0.41 - 1.54)

 

Per mm

  

1.01 (1.00 - 1.02)

 
   

P trend = 0.02

 

Cancer location

Nipple, central portion, upper/lower inner quadrant

143

44 (30.8)

1.15 (0.80 - 1.66)

 

Upper/lower outer quadrant

292

83 (28.4)

1.00

 

Overlapping lesion

147

44 (29.9)

1.07 (0.74 - 1.55)

 

Axillary tail, NOS

84

19 (22.6)

0.75 (0.46 - 1.24)

 

Surgery type

Partial/less than total mastectomy/surgery, NOS

442

108 (24.4)

1.00

1.00

Total mastectomy/modified radical mastectomy

224

82 (36.6)

1.52 (1.13 - 2.04)

1.37 (1.01 - 1.85)

Reconstructive surgery

No

533

150 (28.1)

1.00

 

Yes

105

33 (31.4)

0.98 (0.67 - 1.45)

 

Missing

28

7 (25.0)

-

 

Number of excised lymph nodes

0

143

9 (6.3)

0.13 (0.06 - 0.25)

0.17 (0.08 - 0.33)

1-9c

162

32 (19.8)

0.44 (0.30 - 0.64)

0.46 (0.31 - 0.68)

10+

361

149 (41.3)

1.00

1.00

Per lymph node

  

1.06 (1.04 - 1.08)

1.05 (1.03 - 1.07)

   

P trend <0.001

P trend < 0.001

Radiation

No

270

73 (27.0)

1.00

 

Yes

396

117 (29.6)

1.21 (0.90 - 1.63)

 

Chemotherapy

No

413

83 (20.1)

1.00

1.00

Yes

253

107 (42.3)

2.28 (1.69 - 3.09)

1.48 (1.09 - 2.02)

Tamoxifen

No

382

96 (25.1)

1.00

 

Yes

284

94 (33.1)

1.58 (1.18 - 2.12)

 

Sociodemographic factors

     

Race/ethnicity

Non-Hispanic white (NM, WW)

371

88 (23.7)

1.00

1.00

Black (LA)

226

82 (36.3)

1.62 (1.20 - 2.20)

1.16 (0.83 - 1.61)

Hispanic white (NM)

69

20 (29.0)

1.19 (0.73 - 1.94)

1.04 (0.63 - 1.70)

Marital status

Married

445

123 (27.6)

1.00

 

Widowed

34

10 (29.4)

1.25 (0.64 - 2.43)

 

Divorced/separated

140

46 (32.9)

1.20 (0.86 - 1.69)

 

Never married

47

11 (23.4)

0.85 (0.45 - 1.58)

 

Education

High school or less

158

48 (30.4)

1.00

 

Some college

249

75 (30.1)

0.92 (0.63 - 1.33)

 

College graduate

120

39 (32.5)

1.14 (0.73 - 1.77)

 

Graduate studies

139

28 (20.1)

0.65 (0.40 - 1.07)

 

Insurance

Yes

618

180 (29.1)

1.00

 

No

25

8 (32.0)

1.04 (0.51 - 2.12)

 

Missing

23

2 (8.7)

-

 

Health-related factors

     

Body mass index prior to diagnosis (kg/m2)

<25

306

70 (22.9)

1.00

1.00

25-29.9

220

67 (30.5)

1.40 (0.99 - 1.96)

1.25 (0.88 - 1.76)

30+

140

53 (37.9)

1.83 (1.27 - 2.63)

1.59 (1.09 - 2.31)

Per unit of BMI

  

1.04 (1.02 - 1.07)

1.04 (1.01 - 1.06)

   

P trend < 0.001

P trend = 0.01

Menopausal statusd

Premenopausal

259

82 (31.7)

1.00

 

Postmenopausal

341

80 (23.5)

0.81 (0.51 - 1.28)

 

Unknown

66

28 (42.4)

1.44 (0.91 - 2.26)

 

Hypertension

No

468

122 (26.1)

1.00

1.00

Yes

198

68 (34.3)

1.54 (1.11 - 2.12)

1.49 (1.06 - 2.10)

Diabetes

No

607

174 (28.7)

1.00

 

Yes

59

16 (27.1)

0.96 (0.57 - 1.62)

 

Arthritis

No

480

135 (28.1)

1.00

 

Yes

186

55 (29.6)

1.19 (0.86 - 1.65)

 

Charlson Comorbidity Index

0

599

177 (29.6)

1.00

 

1-2

65

13 (20.0)

0.70 (0.40 - 1.24)

 

Missing

2

0 (0.0)

-

 

Hormonal factors

     

Oral contraceptives use prior to diagnosis

No

189

48 (25.4)

1.00

 

Yes

477

142 (29.8)

1.12 (0.79 - 1.58)

 

Estrogen use prior to diagnosisd,e

No

120

26 (21.7)

1.00

 

Yes

210

52 (24.8)

1.36 (0.83 - 2.24)

 

Missing

11

2 (18.2)

-

 

Progestin use prior to diagnosisd,e

No

205

52 (25.4)

1.00

 

Yes

119

23 (19.3)

0.94 (0.56 - 1.59)

 

Missing

17

5 (29.4)

-

 

Lifestyle factors

     

Pack-years of smoking

<100 cigarettes in lifetime, <0.05 pack-years

326

92 (28.2)

1.00

 

0.05-5.3 pack-years

112

33 (29.5)

1.06 (0.71 - 1.58)

 

5.4-20.5 pack-years

111

37 (33.3)

1.31 (0.89 - 1.93)

 

>20.5 pack-years

114

27 (23.7)

0.93 (0.60 - 1.44)

 

Missing

3

1 (33.3)

-

 

Per pack-year of smoking

  

1.00 (0.99 - 1.01)

 
   

P trend = 0.47

 

Alcohol intake year prior to diagnosis (grams per day)

<1

329

102 (31.0)

1.00

 

1-6

99

25 (25.3)

0.82 (0.52 - 1.28)

 

>6

117

29 (24.8)

0.94 (0.61 - 1.45)

 

Missing

121

34 (28.1)

1.28 (0.79 - 2.09)

 

Per gram of alcohol

  

0.99 (0.97 - 1.01)

 
   

P trend = 0.42

 

Sports and recreational activities year prior to diagnosis (MET hours/week)

<0.5

223

68 (30.5)

1.00

 

0.5-20.0

298

85 (28.5)

1.13 (0.80 - 1.59)

 

>20.0

144

37 (25.7)

1.09 (0.71 - 1.67)

 

Missing

1

0 (0.0)

-

 

Per MET hour

  

1.00 (0.99 - 1.01)

 
   

P trend = 0.80

 
  1. aHR is adjusted for race/ethnicity (non-Hispanic white (New Mexico), non-Hispanic white (Western Washington), black (Los Angeles), Hispanic (New Mexico)) and age at diagnosis (35-44, 45-49, 50-54, 55-59, 60-64). Age is adjusted for only race/ethnicity. Race/ethnicity is adjusted for only age. bCox proportional hazard model includes age, race/ethnicity, surgery type, number of excised lymph nodes, chemotherapy, BMI, and hypertension. c‘1 to 9’ category includes ‘at least one lymph node removed’. dAge in years (35 to 64) was used to adjust for the age effect. eOnly postmenopausal women were included. N, number; LE, lymphedema; HR, hazard ratio; CI, confidence interval; NOS, not otherwise specified; NM, New Mexico; WW, Western Washington; LA, Los Angeles County; BMI, body mass index; MET, metabolic equivalent task.
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Breast Cancer Research

ISSN: 1465-542X

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