{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T14:48:45Z","timestamp":1786978125339,"version":"build-2736575974"},"reference-count":28,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2024,8,27]],"date-time":"2024-08-27T00:00:00Z","timestamp":1724716800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of Surgical Oncology"],"published-print":{"date-parts":[[2024,12]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Breast cancer\u2010related lymphedema is a devastating condition that negatively affects the quality of life of breast cancer survivors. We sought to identify risk factors that predicted the timing and development of lymphedema.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Women with breast cancer that underwent sentinel lymph node biopsy (SLNB) or axillary lymph node dissection (ALND) at our institution between 2007 and 2022 were identified and sociodemographic and clinical information was extracted. We used logistic regression analysis to identify risk factors for lymphedema and performed cox\u2010regression analysis to predict the timing of lymphedema presentation after surgery.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>We identified 1,223 patients, of which 161 (13.2%) developed lymphedema within 1.8 (mean, SD\u2009=\u20092.5) years postoperatively. Patients with SLNB had significantly lower odds for lymphedema development (vs. ALND, OR\u2009=\u20090.29 [0.14\u20130.57]). Patients between 40 and 49 years of age, and 50\u201059 (vs. &lt;40 years, OR\u2009=\u20092.14 [1.00\u20134.60]; OR\u2009=\u20092.42, [1.13\u20135.16] respectively), African American patients (vs. Caucasian, OR\u2009=\u20091.86 [1.12\u20133.09]), patients with stage II, III, and IV disease (vs. stage 0, OR\u2009=\u20093.75 [1.36\u201310.33]; OR\u2009=\u20096.62 [2.14\u201320.51]; OR\u2009=\u20099.36 [2.94\u201329.81]), and patients with Medicaid (vs. private insurance, OR\u2009=\u20093.56 [1.73\u20137.28]) had higher rates of lymphedema. Cox\u2010regression analysis showed that African American (HR\u2009=\u20091.71 [1.08\u20132.70]), higher BMI (HR\u2009=\u20091.03 [1.00\u20131.06]), higher stage (stage II, HR\u2009=\u20092.22 [1.05\u20137.09]; stage III, HR\u2009=\u20095.26 [1.86\u201314.88]; stage IV, HR\u2009=\u20096.13 [2.12\u201317.75]), and Medicaid patients (HR\u2009=\u20092.15 [1.12\u20133.80]) had higher hazards for lymphedema. Patients with SLNB had lower hazards for lymphedema (HR\u2009=\u20090.43 [0.87\u20132.11]).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Lymphedema has identifiable risk factors that can reliably be used to predict the chances of lymphedema development and enable clinicians to educate patients better and formulate treatment plans accordingly.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of Evidence<\/jats:title>\n                    <jats:p>III (Retrospective study).<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/jso.27841","type":"journal-article","created":{"date-parts":[[2024,8,27]],"date-time":"2024-08-27T11:49:40Z","timestamp":1724759380000},"page":"1521-1531","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":13,"title":["Breast cancer\u2010related lymphedema: A comprehensive analysis of risk factors"],"prefix":"10.1002","volume":"130","author":[{"given":"Charalampos","family":"Siotos","sequence":"first","affiliation":[{"name":"Division of Plastic and Reconstructive Surgery Rush University Medical Center Chicago Illinois USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sydney H.","family":"Arnold","sequence":"additional","affiliation":[{"name":"Division of Plastic and Reconstructive Surgery Rush University Medical Center Chicago Illinois USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michelle","family":"Seu","sequence":"additional","affiliation":[{"name":"Division of Plastic and Reconstructive Surgery Rush University Medical Center Chicago Illinois USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lilia","family":"Lunt","sequence":"additional","affiliation":[{"name":"Department of Surgery Rush University Medical Center Chicago Illinois USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1192-1687","authenticated-orcid":false,"given":"Jennifer","family":"Ferraro","sequence":"additional","affiliation":[{"name":"Division of Plastic and Reconstructive Surgery Rush University Medical Center Chicago Illinois USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel","family":"Najafali","sequence":"additional","affiliation":[{"name":"Division of Plastic and Reconstructive Surgery Rush University Medical Center Chicago Illinois USA"},{"name":"Department of Surgery, Carle Illinois College of Medicine University of Illinois at Urbana\u2010Champaign Urbana Illinois USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"George","family":"Damoulakis","sequence":"additional","affiliation":[{"name":"Department of Mechanical and Industrial Engineering University of Illinois at Chicago Chicago Illinois USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joshua","family":"Vorstenbosch","sequence":"additional","affiliation":[{"name":"Department of Surgery, Royal Victoria Hospital McGill University Montreal Quebec Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Babak J.","family":"Mehrara","sequence":"additional","affiliation":[{"name":"Department of Surgery Memorial Sloan Kettering Cancer Center New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anuja K.","family":"Antony","sequence":"additional","affiliation":[{"name":"Division of Plastic and Reconstructive Surgery Rush University Medical Center Chicago Illinois USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Deana S.","family":"Shenaq","sequence":"additional","affiliation":[{"name":"Division of Plastic and Reconstructive Surgery Rush University Medical Center Chicago Illinois USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"George","family":"Kokosis","sequence":"additional","affiliation":[{"name":"Division of Plastic and Reconstructive Surgery Rush University Medical Center Chicago Illinois USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,8,27]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1470-2045(13)70076-7"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1002\/jso.24414"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1002\/pon.1573"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.critrevonc.2014.06.004"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamasurg.2020.0230"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCRESAHA.121.318307"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1097\/SAP.0000000000001542"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00520-018-4186-1"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1097\/SLA.0000000000005671"},{"key":"e_1_2_8_11_1","unstructured":"TeshomeMBK McCallLM CormierJN GuilianoAE HuntKK. Long\u2010term incidence of lymphedema after sentinel lymph node dissection for early stage breast cancer: ACOSOG Z0010 (Alliance) Presented at: 67th Annual Cancer Symposium Society of Surgical Oncology.2014"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamasurg.2014.44"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamasurg.2023.2414"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10549-016-3913-x"},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00520-011-1285-7"},{"key":"e_1_2_8_16_1","doi-asserted-by":"publisher","DOI":"10.1158\/1055-9965.EPI-09-1245"},{"key":"e_1_2_8_17_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1524-4741.2009.00878.x"},{"key":"e_1_2_8_18_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2008.18.3517"},{"key":"e_1_2_8_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjsurg.2019.06.023"},{"key":"e_1_2_8_20_1","unstructured":"JiangHJ WeissAJ BarrettML ShengM. Characteristics of hospital stays for Super\u2010Utilizers by Payer 2012 Healthcare Cost and Utilization Project (HCUP) Statistical Briefs. Agency for Healthcare Research and Quality (US).2006."},{"key":"e_1_2_8_21_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1415340"},{"key":"e_1_2_8_22_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijrobp.2013.11.232"},{"key":"e_1_2_8_23_1","doi-asserted-by":"publisher","DOI":"10.1097\/SAP.0000000000001864"},{"key":"e_1_2_8_24_1","doi-asserted-by":"publisher","DOI":"10.1097\/PRS.0b013e3181c49477"},{"key":"e_1_2_8_25_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bjps.2018.01.012"},{"key":"e_1_2_8_26_1","doi-asserted-by":"publisher","DOI":"10.1097\/SLA.0000000000001128"},{"key":"e_1_2_8_27_1","doi-asserted-by":"publisher","DOI":"10.1002\/bjs.10397"},{"key":"e_1_2_8_28_1","doi-asserted-by":"publisher","DOI":"10.1097\/PRS.0b013e31824a2ab1"},{"key":"e_1_2_8_29_1","doi-asserted-by":"publisher","DOI":"10.1097\/00006534-199703000-00020"}],"container-title":["Journal of Surgical Oncology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/jso.27841","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,3,12]],"date-time":"2025-03-12T03:57:13Z","timestamp":1741751833000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/jso.27841"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,8,27]]},"references-count":28,"journal-issue":{"issue":"8","published-print":{"date-parts":[[2024,12]]}},"alternative-id":["10.1002\/jso.27841"],"URL":"https:\/\/doi.org\/10.1002\/jso.27841","archive":["Portico"],"relation":{},"ISSN":["0022-4790","1096-9098"],"issn-type":[{"value":"0022-4790","type":"print"},{"value":"1096-9098","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,8,27]]},"assertion":[{"value":"2024-06-04","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-08-11","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-08-27","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}