{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,2]],"date-time":"2026-11-02T19:43:33Z","timestamp":1793648613060,"version":"4.5.1"},"reference-count":56,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2025,11,20]],"date-time":"2025-11-20T00:00:00Z","timestamp":1763596800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2025,11,20]],"date-time":"2025-11-20T00:00:00Z","timestamp":1763596800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Breast Cancer Res Treat"],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>Breast cancer-related lymphedema (BCRL) disproportionately impacts patients facing socioeconomic challenges. The influence of socioeconomic disparities on preventive procedures such as immediate lymphatic reconstruction (ILR) is unclear. We sought to determine the impact of area deprivation index (ADI) on BCRL incidence and patient-reported outcomes (PROs) following ILR.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We retrospectively studied consecutive patients who underwent ILR following ALND between 2017 and 2024 across multiple hospitals within a hospital network. Patients were stratified into quartiles based on ADI (Q1\u2009=\u2009least deprived, Q4\u2009=\u2009most deprived). BCRL prevalence and condition-specific (LYMPH-Q) quality-of-life performance was compared and correlated across quartiles via multivariable regression, including subgroup analysis by ethnicity.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      We identified 172 patients with follow-up time of 23.1\u2009\u00b1\u200915.2\u00a0months. Patients residing in the most deprived neighborhoods (ADI Q4) demonstrated significantly higher BCRL rates compared to those from less deprived neighborhoods (Q1-3) (16.3% vs. 3.9%;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.006). In multivariable regression, residence in the most deprived neighborhoods remained independently associated with a significantly higher risk of BCRL (OR 5.10, 95% CI 1.30\u201320.30;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.021). Subgroup analysis revealed that Black patients in the highest ADI quartile reported significantly worse LYMPH-Q function scores (median 62.0 vs 100.0; p\u2009=\u20090.020), compared to Black patients residing in less deprived areas. ADI was not significantly associated with surgical complications or unplanned reoperations.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Neighborhood socioeconomic disadvantage significantly increases BCRL risk following ILR and is associated with significantly worse patient-reported functional outcomes among Black patients. Targeted interventions addressing neighborhood-level factors are critical to mitigate these disparities and ensure equitable outcomes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s10549-025-07829-w","type":"journal-article","created":{"date-parts":[[2025,11,20]],"date-time":"2025-11-20T12:45:48Z","timestamp":1763642748000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Socioeconomic and ethnic disparities in breast cancer-related lymphedema and quality-of-life after immediate lymphatic reconstruction"],"prefix":"10.1007","volume":"215","author":[{"given":"Abbas M.","family":"Hassan","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John P.","family":"Hajj","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John P.","family":"Lewis","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carla S.","family":"Fisher","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Folasade O.","family":"Imeokparia","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kandice K.","family":"Ludwig","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rachel M.","family":"Danforth","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R. Jason","family":"VonDerHaar","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ravinder","family":"Bamba","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mary E.","family":"Lester","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aladdin H.","family":"Hassanein","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,11,20]]},"reference":[{"issue":"9","key":"7829_CR1","doi-asserted-by":"publisher","DOI":"10.1097\/gox.0000000000006166","volume":"12","author":"KN Fallah","year":"2024","unstructured":"Fallah KN, Ahmed S, Venardi AS, Hulsman LA, Fisher CS, Ludwig KK, Lester ME, Hassanein AH (2024) Prophylactic buried dermal flap: a simple method for axillary reconstruction after lymph node dissection. Plast Reconstr Surg Glob Open 12(9):e6166. https:\/\/doi.org\/10.1097\/gox.0000000000006166","journal-title":"Plast Reconstr Surg Glob Open"},{"key":"7829_CR2","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1016\/j.bjps.2024.04.060","volume":"94","author":"R Friedman","year":"2024","unstructured":"Friedman R, Ismail Aly MA, Fanning JE, Pardo JA, Johnson AR, Lee BT, James T, Singhal D (2024) Immediate lymphatic reconstruction: lessons learned over eight years. J Plast Reconstr Aesthet Surg 94:1\u201311. https:\/\/doi.org\/10.1016\/j.bjps.2024.04.060","journal-title":"J Plast Reconstr Aesthet Surg"},{"issue":"3","key":"7829_CR3","doi-asserted-by":"publisher","first-page":"703","DOI":"10.1245\/s10434-008-0270-y","volume":"16","author":"F Boccardo","year":"2009","unstructured":"Boccardo F, Casabona F, De Cian F, Friedman D, Villa G, Bogliolo S, Ferrero S, Murelli F, Campisi C (2009) Lymphedema microsurgical preventive healing approach: a new technique for primary prevention of arm lymphedema after mastectomy. Ann Surg Oncol 16(3):703\u2013708. https:\/\/doi.org\/10.1245\/s10434-008-0270-y","journal-title":"Ann Surg Oncol"},{"issue":"1","key":"7829_CR4","doi-asserted-by":"publisher","first-page":"53","DOI":"10.1089\/lrb.2020.0120","volume":"20","author":"T Karlsson","year":"2022","unstructured":"Karlsson T, Karlsson M, Ohlin K, Olsson G, Brorson H (2022) Liposuction of breast cancer-related arm lymphedema reduces fat and muscle hypertrophy. Lymphat Res Biol 20(1):53\u201363. https:\/\/doi.org\/10.1089\/lrb.2020.0120","journal-title":"Lymphat Res Biol"},{"key":"7829_CR5","doi-asserted-by":"publisher","DOI":"10.1055\/s-0044-1787727","author":"S Ahmed","year":"2024","unstructured":"Ahmed S, Hulsman L, Roth D et al (2024) Evaluating operative times for intraoperative conversion of axillary node biopsy to axillary lymph node dissection with immediate lymphatic reconstruction. J Reconstr Microsurg. https:\/\/doi.org\/10.1055\/s-0044-1787727","journal-title":"J Reconstr Microsurg"},{"issue":"3","key":"7829_CR6","doi-asserted-by":"publisher","first-page":"1381","DOI":"10.1245\/s10434-020-09104-2","volume":"28","author":"JA Cook","year":"2021","unstructured":"Cook JA, Sasor SE, Loewenstein SN, DeBrock W, Lester M, Socas J, Ludwig KK, Fisher CS, Hassanein AH (2021) Immediate lymphatic reconstruction after axillary lymphadenectomy: a single-institution early experience. Ann Surg Oncol 28(3):1381\u20131387. https:\/\/doi.org\/10.1245\/s10434-020-09104-2","journal-title":"Ann Surg Oncol"},{"issue":"12","key":"7829_CR7","doi-asserted-by":"publisher","first-page":"4695","DOI":"10.1245\/s10434-020-08890-z","volume":"27","author":"K Shaffer","year":"2020","unstructured":"Shaffer K, Cakmakoglu C, Schwarz GS, ElSherif A, Al-Hilli Z, Djohan R, Radford DM, Grobmyer S, Bernard S, Moreira A, Fanning A, Tu C, Valente SA (2020) Lymphedema prevention surgery: improved operating efficiency over time. Ann Surg Oncol 27(12):4695\u20134701. https:\/\/doi.org\/10.1245\/s10434-020-08890-z","journal-title":"Ann Surg Oncol"},{"issue":"4","key":"7829_CR8","doi-asserted-by":"publisher","first-page":"630","DOI":"10.1097\/sla.0000000000005952","volume":"278","author":"M Coriddi","year":"2023","unstructured":"Coriddi M, Dayan J, Bloomfield E, McGrath L, Diwan R, Monge J, Gutierrez J, Brown S, Boe L, Mehrara B (2023) Efficacy of immediate lymphatic reconstruction to decrease incidence of breast cancer-related lymphedema: preliminary results of randomized controlled trial. Ann Surg 278(4):630\u2013637. https:\/\/doi.org\/10.1097\/sla.0000000000005952","journal-title":"Ann Surg"},{"issue":"5","key":"7829_CR9","doi-asserted-by":"publisher","first-page":"773e","DOI":"10.1097\/prs.0000000000010381","volume":"152","author":"MD Granoff","year":"2023","unstructured":"Granoff MD, Fleishman A, Shillue K, Johnson AR, Ross JoEllen, Lee BT, Teller P, James TA, Singhal D (2023) A 4-year institutional experience of immediate lymphatic reconstruction. Plast Reconstr Surg 152(5):773e\u2013778e. https:\/\/doi.org\/10.1097\/prs.0000000000010381","journal-title":"Plast Reconstr Surg"},{"issue":"6S Suppl 4","key":"7829_CR10","doi-asserted-by":"publisher","first-page":"S363","DOI":"10.1097\/sap.0000000000003457","volume":"90","author":"NK Le","year":"2023","unstructured":"Le NK, Liu L, Jesus Cruz R et al (2023) Efficacy of immediate lymphatic reconstruction in prevention of breast cancer - related lymphedema. Ann Plast Surg 90(6S Suppl 4):S363-s365. https:\/\/doi.org\/10.1097\/sap.0000000000003457","journal-title":"Ann Plast Surg"},{"issue":"4","key":"7829_CR11","doi-asserted-by":"publisher","first-page":"262","DOI":"10.1055\/a-2153-2203","volume":"40","author":"NK Le","year":"2024","unstructured":"Le NK, Weinstein B, Parikh J, Coomar LA, Wainwright D, Liu L, Mammadova J, Tavares T, Panetta NJ (2024) Immediate lymphatic reconstruction in 77 consecutive breast cancer patients: 2-year follow-up. J Reconstr Microsurg 40(4):262\u2013267. https:\/\/doi.org\/10.1055\/a-2153-2203","journal-title":"J Reconstr Microsurg"},{"issue":"9","key":"7829_CR12","doi-asserted-by":"publisher","first-page":"713","DOI":"10.1055\/s-0044-1785680","volume":"40","author":"MC M\u00e9dor","year":"2024","unstructured":"M\u00e9dor MC, Churchill IF, Pereira D, Roberts A, Cordeiro E, Findlay-Shirras L, Zhang J, Momtazi M (2024) Lymphovenous bypass for immediate lymphatic reconstruction in breast cancer patients undergoing axillary lymph node dissection: minimizing the risk of upper extremity lymphedema. J Reconstr Microsurg 40(9):713\u2013721. https:\/\/doi.org\/10.1055\/s-0044-1785680","journal-title":"J Reconstr Microsurg"},{"issue":"11","key":"7829_CR13","doi-asserted-by":"publisher","first-page":"7349","DOI":"10.1245\/s10434-024-15715-w","volume":"31","author":"JW Jakub","year":"2024","unstructured":"Jakub JW, Boughey JC, Hieken TJ, Piltin M, Forte AJ, Vijayasekaran A, Mazur M, Sturz J, Corbin K, Vallow L, Johnson JE, Mrdutt M, Fahradyan V, Li Z, Blumenfeld S, Degnim A, Yost KJ, Cheville A, McLaughlin SA (2024) Lymphedema rates following axillary lymph node dissection with and without immediate lymphatic reconstruction: a prospective trial. Ann Surg Oncol 31(11):7349\u20137359. https:\/\/doi.org\/10.1245\/s10434-024-15715-w","journal-title":"Ann Surg Oncol"},{"issue":"3","key":"7829_CR14","doi-asserted-by":"publisher","first-page":"373e","DOI":"10.1097\/prs.0000000000007636","volume":"147","author":"AR Johnson","year":"2021","unstructured":"Johnson AR, Fleishman A, Granoff MD, Shillue K, Houlihan MJ, Sharma R, Kansal KJ, Teller P, James TA, Lee BT, Singhal D (2021) Evaluating the impact of immediate lymphatic reconstruction for the surgical prevention of lymphedema. Plast Reconstr Surg 147(3):373e\u2013381e. https:\/\/doi.org\/10.1097\/prs.0000000000007636","journal-title":"Plast Reconstr Surg"},{"issue":"2","key":"7829_CR15","doi-asserted-by":"publisher","first-page":"160","DOI":"10.1002\/jso.25513","volume":"120","author":"GS Schwarz","year":"2019","unstructured":"Schwarz GS, Grobmyer SR, Djohan RS, Cakmakoglu C, Bernard SL, Radford D, Al\u2010Hilli Z, Knackstedt R, Djohan M, Valente SA (2019) Axillary reverse mapping and lymphaticovenous bypass: lymphedema prevention through enhanced lymphatic visualization and restoration of flow. J Surg Oncol 120(2):160\u2013167. https:\/\/doi.org\/10.1002\/jso.25513","journal-title":"J Surg Oncol"},{"issue":"7","key":"7829_CR16","doi-asserted-by":"publisher","first-page":"382","DOI":"10.1089\/wound.2021.0056","volume":"11","author":"JA Cook","year":"2022","unstructured":"Cook JA, Sinha M, Lester M, Fisher CS, Sen CK, Hassanein AH (2022) Immediate lymphatic reconstruction to prevent breast cancer-related lymphedema: a systematic review. Adv Wound Care 11(7):382\u2013391. https:\/\/doi.org\/10.1089\/wound.2021.0056","journal-title":"Adv Wound Care"},{"key":"7829_CR17","doi-asserted-by":"publisher","DOI":"10.1245\/s10434-025-17301-0","author":"AMHJ Hassan","year":"2025","unstructured":"Hassan AMHJ, Lewis JP et al (2025) Long-Term Outcomes of Lymphedema After Immediate Lymphatic Reconstruction Following Axillary Lymph Node Dissection. Ann Surg Oncol. https:\/\/doi.org\/10.1245\/s10434-025-17301-0","journal-title":"Ann Surg Oncol"},{"issue":"14","key":"7829_CR18","doi-asserted-by":"publisher","first-page":"2314","DOI":"10.1002\/cncr.29345","volume":"121","author":"SL Gomez","year":"2015","unstructured":"Gomez SL, Shariff-Marco S, DeRouen M et al (2015) The impact of neighborhood social and built environment factors across the cancer continuum: current research, methodological considerations, and future directions. Cancer 121(14):2314\u20132330. https:\/\/doi.org\/10.1002\/cncr.29345","journal-title":"Cancer"},{"issue":"3","key":"7829_CR19","doi-asserted-by":"publisher","first-page":"786","DOI":"10.1016\/j.jvs.2018.10.123","volume":"70","author":"RB Hawkins","year":"2019","unstructured":"Hawkins RB, Charles EJ, Mehaffey JH, Williams CA, Robinson WP, Upchurch GR, Kern JA, Tracci MC (2019) Socioeconomic distressed communities index associated with worse limb - related outcomes after infrainguinal bypass. J Vasc Surg 70(3):786-794.e2. https:\/\/doi.org\/10.1016\/j.jvs.2018.10.123","journal-title":"J Vasc Surg"},{"issue":"Suppl 2","key":"7829_CR20","doi-asserted-by":"publisher","first-page":"19","DOI":"10.1177\/00333549141291s206","volume":"129","author":"P Braveman","year":"2014","unstructured":"Braveman P, Gottlieb L (2014) The social determinants of health: it\u2019s time to consider the causes of the causes. Public Health Rep 129(Suppl 2):19\u201331. https:\/\/doi.org\/10.1177\/00333549141291s206. (Suppl 2)","journal-title":"Public Health Rep"},{"issue":"4","key":"7829_CR21","doi-asserted-by":"publisher","first-page":"861","DOI":"10.1016\/j.healthplace.2012.03.005","volume":"18","author":"LR Reitzel","year":"2012","unstructured":"Reitzel LR, Nguyen N, Zafereo ME, Li G, Wei Q, Sturgis EM (2012) Neighborhood deprivation and clinical outcomes among head and neck cancer patients. Health Place 18(4):861\u2013868. https:\/\/doi.org\/10.1016\/j.healthplace.2012.03.005","journal-title":"Health Place"},{"issue":"3","key":"7829_CR22","doi-asserted-by":"publisher","first-page":"795","DOI":"10.1007\/s11605-020-04754-9","volume":"25","author":"FM Ghirimoldi","year":"2021","unstructured":"Ghirimoldi FM, Schmidt S, Simon RC, Wang C-P, Wang Z, Brimhall BB, Damien P, Moffett EE, Manuel LS, Sarwar ZU, Shireman PK (2021) Association of socioeconomic area deprivation index with hospital readmissions after colon and rectal surgery. J Gastrointest Surg 25(3):795\u2013808. https:\/\/doi.org\/10.1007\/s11605-020-04754-9","journal-title":"J Gastrointest Surg"},{"issue":"1","key":"7829_CR23","doi-asserted-by":"publisher","first-page":"8","DOI":"10.1089\/heq.2020.0037","volume":"5","author":"MQ Rosenzweig","year":"2021","unstructured":"Rosenzweig MQ, Althouse AD, Sabik L et al (2021) The association between area deprivation index and patient-reported outcomes in patients with advanced cancer. Health Equity 5(1):8\u201316. https:\/\/doi.org\/10.1089\/heq.2020.0037","journal-title":"Health Equity"},{"issue":"2","key":"7829_CR24","doi-asserted-by":"publisher","first-page":"131","DOI":"10.7326\/m19-1510","volume":"171","author":"GK Singh","year":"2019","unstructured":"Singh GK, Lin CC (2019) Area deprivation and inequalities in health and health care outcomes. Ann Intern Med 171(2):131\u2013132. https:\/\/doi.org\/10.7326\/m19-1510","journal-title":"Ann Intern Med"},{"issue":"6","key":"7829_CR25","doi-asserted-by":"publisher","first-page":"881","DOI":"10.1097\/sla.0000000000004691","volume":"274","author":"A Diaz","year":"2021","unstructured":"Diaz A, Hyer JM, Barmash E, Azap R, Paredes AZ, Pawlik TM (2021) County-level social vulnerability is associated with worse surgical outcomes especially among minority patients. Ann Surg 274(6):881\u2013891. https:\/\/doi.org\/10.1097\/sla.0000000000004691","journal-title":"Ann Surg"},{"key":"7829_CR26","doi-asserted-by":"publisher","DOI":"10.1016\/j.jamcollsurg.2020.11.024","author":"JM Hyer","year":"2021","unstructured":"Hyer JM, Tsilimigras DI, Diaz A et al (2021) High Social Vulnerability and \u201cTextbook Outcomes\u201d after Cancer Operation. J Am Coll Surg. https:\/\/doi.org\/10.1016\/j.jamcollsurg.2020.11.024","journal-title":"J Am Coll Surg"},{"issue":"1","key":"7829_CR27","doi-asserted-by":"publisher","first-page":"80","DOI":"10.1245\/s10434-022-12506-z","volume":"30","author":"AM Hassan","year":"2023","unstructured":"Hassan AM, Nguyen HT, Corkum JP, Liu J, Kapur SK, Chu CK, Tamirisa N, Offodile AC 2nd (2023) Area deprivation index is associated with variation in quality of life and psychosocial well-being following breast cancer surgery. Ann Surg Oncol 30(1):80\u201387. https:\/\/doi.org\/10.1245\/s10434-022-12506-z","journal-title":"Ann Surg Oncol"},{"issue":"6","key":"7829_CR28","doi-asserted-by":"publisher","first-page":"444","DOI":"10.1055\/a-1947-8212","volume":"39","author":"SN Chiang","year":"2023","unstructured":"Chiang SN, Finnan MJ, Varagur K, Skolnick GB, Sacks JM, Christensen JM (2023) The association between breast cancer related lymphedema and area deprivation index. J Reconstr Microsurg 39(6):444\u2013452. https:\/\/doi.org\/10.1055\/a-1947-8212","journal-title":"J Reconstr Microsurg"},{"issue":"26","key":"7829_CR29","doi-asserted-by":"publisher","first-page":"2456","DOI":"10.1056\/NEJMp1802313","volume":"378","author":"AJH Kind","year":"2018","unstructured":"Kind AJH, Buckingham WR (2018) Making neighborhood-disadvantage metrics accessible - the neighborhood atlas. N Engl J Med 378(26):2456\u20132458. https:\/\/doi.org\/10.1056\/NEJMp1802313","journal-title":"N Engl J Med"},{"issue":"6","key":"7829_CR30","doi-asserted-by":"publisher","first-page":"1041","DOI":"10.1007\/s11524-006-9094-x","volume":"83","author":"LC Messer","year":"2006","unstructured":"Messer LC, Laraia BA, Kaufman JS, Eyster J, Holzman C, Culhane J, Elo I, Burke JG, O\u2019Campo P (2006) The development of a standardized neighborhood deprivation index. J Urban Health 83(6):1041\u20131062. https:\/\/doi.org\/10.1007\/s11524-006-9094-x","journal-title":"J Urban Health"},{"issue":"3","key":"7829_CR31","doi-asserted-by":"publisher","first-page":"232","DOI":"10.1136\/bmjqs-2019-009800","volume":"29","author":"JH Mehaffey","year":"2020","unstructured":"Mehaffey JH, Hawkins RB, Charles EJ, Turrentine FE, Kaplan B, Fogel S, Harris C, Reines D, Posadas J, Ailawadi G, Hanks JB, Hallowell PT, Jones RS (2020) Community level socioeconomic status association with surgical outcomes and resource utilisation in a regional cohort: a prospective registry analysis. BMJ Qual Saf 29(3):232\u2013237. https:\/\/doi.org\/10.1136\/bmjqs-2019-009800","journal-title":"BMJ Qual Saf"},{"issue":"3","key":"7829_CR32","doi-asserted-by":"publisher","first-page":"470","DOI":"10.1097\/sla.0000000000002997","volume":"271","author":"JH Mehaffey","year":"2020","unstructured":"Mehaffey JH, Hawkins RB, Charles EJ, Turrentine FE, Hallowell PT, Friel C, Jones RS, Tracci MC (2020) Socioeconomic \u201cDistressed Communities Index\u201d improves surgical risk-adjustment. Ann Surg 271(3):470\u2013474. https:\/\/doi.org\/10.1097\/sla.0000000000002997","journal-title":"Ann Surg"},{"issue":"13","key":"7829_CR33","doi-asserted-by":"publisher","first-page":"8665","DOI":"10.1245\/s10434-021-10290-w","volume":"28","author":"C Furlan","year":"2021","unstructured":"Furlan C, Matheus CN, Jales RM, Derchain SFM, Bennini JR Jr., Sarian LO (2021) Longitudinal, long-term comparison of single- versus multipoint upper limb circumference periodical measurements as a tool to predict persistent lymphedema in women treated surgically for breast cancer: an optimized strategy to early diagnose lymphedema and avoid permanent sequelae in breast cancer survivors. Ann Surg Oncol 28(13):8665\u20138676. https:\/\/doi.org\/10.1245\/s10434-021-10290-w","journal-title":"Ann Surg Oncol"},{"issue":"2","key":"7829_CR34","doi-asserted-by":"publisher","DOI":"10.1097\/gox.0000000000003431","volume":"9","author":"M Coriddi","year":"2021","unstructured":"Coriddi M, Mehrara B, Skoracki R, Singhal D, Dayan JH (2021) Immediate lymphatic reconstruction: technical points and literature review. Plast Reconstr Surg-Global Open 9(2):e3431. https:\/\/doi.org\/10.1097\/gox.0000000000003431","journal-title":"Plast Reconstr Surg-Global Open"},{"issue":"8","key":"7829_CR35","doi-asserted-by":"publisher","first-page":"2831","DOI":"10.1016\/j.bjps.2022.06.076","volume":"75","author":"R Friedman","year":"2022","unstructured":"Friedman R, Bustos VP, Postian T, Pardo J, Hamaguchi R, Lee BT, James TA, Singhal D (2022) Utilizing a lower extremity vein graft for immediate lymphatic reconstruction. J Plast Reconstr Aesthet Surg 75(8):2831\u20132870. https:\/\/doi.org\/10.1016\/j.bjps.2022.06.076","journal-title":"J Plast Reconstr Aesthet Surg"},{"key":"7829_CR36","doi-asserted-by":"publisher","DOI":"10.1245\/s10434-024-16047-5","author":"S Ahmed","year":"2024","unstructured":"Ahmed S, Mercho PF, Brown WA et al (2024) Effect of immediate lymphatic reconstruction on postmastectomy implant reconstruction. Ann Surg Oncol. https:\/\/doi.org\/10.1245\/s10434-024-16047-5","journal-title":"Ann Surg Oncol"},{"issue":"9","key":"7829_CR37","doi-asserted-by":"publisher","first-page":"5166","DOI":"10.1245\/s10434-021-09887-y","volume":"28","author":"AF Klassen","year":"2021","unstructured":"Klassen AF, Tsangaris E, Kaur MN, Poulsen L, Beelen LM, Jacobsen AL, J\u00f8rgensen MG, S\u00f8rensen JA, Vasilic D, Dayan J, Mehrara B, Pusic AL (2021) Development and psychometric validation of a patient-reported outcome measure for arm lymphedema: the LYMPH-Q upper extremity module. Ann Surg Oncol 28(9):5166\u20135182. https:\/\/doi.org\/10.1245\/s10434-021-09887-y","journal-title":"Ann Surg Oncol"},{"issue":"8","key":"7829_CR38","doi-asserted-by":"publisher","first-page":"876","DOI":"10.1001\/jamaophthalmol.2020.2254","volume":"138","author":"N Rajeshuni","year":"2020","unstructured":"Rajeshuni N, Zubair T, Ludwig CA, Moshfeghi DM, Mruthyunjaya P (2020) Evaluation of racial, ethnic, and socioeconomic associations with treatment and survival in uveal melanoma, 2004\u20132014. JAMA Ophthalmol 138(8):876\u2013884. https:\/\/doi.org\/10.1001\/jamaophthalmol.2020.2254","journal-title":"JAMA Ophthalmol"},{"issue":"8","key":"7829_CR39","doi-asserted-by":"publisher","first-page":"1027","DOI":"10.1038\/eye.2015.51","volume":"29","author":"CL Shields","year":"2015","unstructured":"Shields CL, Kaliki S, Cohen MN, Shields PW, Furuta M, Shields JA (2015) Prognosis of uveal melanoma based on race in 8100 patients: the 2015 Doyne Lecture. Eye Lond 29(8):1027\u20131035. https:\/\/doi.org\/10.1038\/eye.2015.51","journal-title":"Eye Lond"},{"issue":"1","key":"7829_CR40","doi-asserted-by":"publisher","first-page":"57","DOI":"10.1016\/s0002-9394(14)72842-9","volume":"118","author":"HL Hudson","year":"1994","unstructured":"Hudson HL, Valluri S, Rao NA (1994) Choroidal melanomas in Hispanic patients. Am J Ophthalmol 118(1):57\u201362. https:\/\/doi.org\/10.1016\/s0002-9394(14)72842-9","journal-title":"Am J Ophthalmol"},{"issue":"10","key":"7829_CR41","doi-asserted-by":"publisher","first-page":"2882","DOI":"10.1158\/1055-9965.Epi-08-0221","volume":"17","author":"ER Smith","year":"2008","unstructured":"Smith ER, Adams SA, Das IP, Bottai M, Fulton J, Hebert JR (2008) Breast cancer survival among economically disadvantaged women: the influences of delayed diagnosis and treatment on mortality. Cancer Epidemiol Biomarkers Prev 17(10):2882\u20132890. https:\/\/doi.org\/10.1158\/1055-9965.Epi-08-0221","journal-title":"Cancer Epidemiol Biomarkers Prev"},{"issue":"24","key":"7829_CR42","doi-asserted-by":"publisher","first-page":"5788","DOI":"10.1002\/cncr.24633","volume":"115","author":"SA Adams","year":"2009","unstructured":"Adams SA, Smith ER, Hardin J, Prabhu-Das I, Fulton J, Hebert JR (2009) Racial differences in follow-up of abnormal mammography findings among economically disadvantaged women. Cancer 115(24):5788\u20135797. https:\/\/doi.org\/10.1002\/cncr.24633","journal-title":"Cancer"},{"key":"7829_CR43","doi-asserted-by":"publisher","DOI":"10.1097\/sla.0000000000005475","author":"A Diaz","year":"2022","unstructured":"Diaz A, Valbuena VSM, Dimick JB, Ibrahim AM (2022) Association of Neighborhood Deprivation, Race, and Postoperative Outcomes: Improvement in Neighborhood Deprivation is Associated With Worsening Surgical Disparities. Ann Surg. https:\/\/doi.org\/10.1097\/sla.0000000000005475","journal-title":"Ann Surg"},{"issue":"3","key":"7829_CR44","doi-asserted-by":"publisher","first-page":"496","DOI":"10.1038\/s41390-020-0755-3","volume":"88","author":"AK Sharma","year":"2020","unstructured":"Sharma AK, Kroeker K, Chateau D, Brownell M, Rodd CJ (2020) Assessing childhood health outcome inequalities with area-based socioeconomic measures: a retrospective cross-sectional study using Manitoba population data. Pediatr Res 88(3):496\u2013502. https:\/\/doi.org\/10.1038\/s41390-020-0755-3","journal-title":"Pediatr Res"},{"issue":"1","key":"7829_CR45","doi-asserted-by":"publisher","first-page":"81","DOI":"10.1353\/hpu.2018.0009","volume":"29","author":"AJ Knighton","year":"2018","unstructured":"Knighton AJ, Stephenson B, Savitz LA (2018) Measuring the effect of social determinants on patient outcomes: a systematic literature review. J Health Care Poor Underserved 29(1):81\u2013106. https:\/\/doi.org\/10.1353\/hpu.2018.0009","journal-title":"J Health Care Poor Underserved"},{"issue":"8","key":"7829_CR46","doi-asserted-by":"publisher","first-page":"1195","DOI":"10.1001\/jamaoncol.2022.1628","volume":"8","author":"G Montagna","year":"2022","unstructured":"Montagna G, Zhang J, Sevilimedu V et al (2022) Risk factors and racial and ethnic disparities in patients with breast cancer-related lymphedema. JAMA Oncol 8(8):1195\u20131200. https:\/\/doi.org\/10.1001\/jamaoncol.2022.1628","journal-title":"JAMA Oncol"},{"issue":"20","key":"7829_CR47","doi-asserted-by":"publisher","first-page":"2341","DOI":"10.1200\/jco.19.02896","volume":"38","author":"SA McLaughlin","year":"2020","unstructured":"McLaughlin SA, Brunelle CL, Taghian A (2020) Breast cancer-related lymphedema: risk factors, screening, management, and the impact of locoregional treatment. J Clin Oncol 38(20):2341\u20132350. https:\/\/doi.org\/10.1200\/jco.19.02896","journal-title":"J Clin Oncol"},{"issue":"6","key":"7829_CR48","doi-asserted-by":"publisher","first-page":"668","DOI":"10.1001\/jamasurg.2024.0118","volume":"159","author":"DR Heller","year":"2024","unstructured":"Heller DR, Axelrod B, Sevilimedu V, Morrow M, Mehrara BJ, Barrio AV (2024) Quality of life after axillary lymph node dissection among racial and ethnic minority women. JAMA Surg 159(6):668\u2013676. https:\/\/doi.org\/10.1001\/jamasurg.2024.0118","journal-title":"JAMA Surg"},{"issue":"8","key":"7829_CR49","doi-asserted-by":"publisher","first-page":"788","DOI":"10.1001\/jamasurg.2014.23","volume":"149","author":"DM Black","year":"2014","unstructured":"Black DM, Jiang J, Kuerer HM, Buchholz TA, Smith BD (2014) Racial disparities in adoption of axillary sentinel lymph node biopsy and lymphedema risk in women with breast cancer. JAMA Surg 149(8):788\u2013796. https:\/\/doi.org\/10.1001\/jamasurg.2014.23","journal-title":"JAMA Surg"},{"issue":"1","key":"7829_CR50","doi-asserted-by":"publisher","first-page":"119","DOI":"10.1007\/s10549-016-3913-x","volume":"159","author":"ML Kwan","year":"2016","unstructured":"Kwan ML, Yao S, Lee VS, Roh JM, Zhu Q, Ergas IJ, Liu Q, Zhang Y, Kutner SE, Quesenberry CP Jr., Ambrosone CB, Kushi LH (2016) Race\/ethnicity, genetic ancestry, and breast cancer-related lymphedema in the Pathways Study. Breast Cancer Res Treat 159(1):119\u2013129. https:\/\/doi.org\/10.1007\/s10549-016-3913-x","journal-title":"Breast Cancer Res Treat"},{"key":"7829_CR51","unstructured":"Network LEaR. National Indicator Report on Cancer-Related Lymphedema (LE). 2024. https:\/\/lymphaticnetwork.org\/documents\/National_Indicator_Report_on_Cancer-Related_Lymphedema.pdf"},{"issue":"1","key":"7829_CR52","doi-asserted-by":"publisher","first-page":"25","DOI":"10.1245\/s10434-021-10792-7","volume":"29","author":"E Matros","year":"2022","unstructured":"Matros E, Offodile AC (2022) Financial toxicity following post-mastectomy reconstruction: consideration for a novel outcome measure. Ann Surg Oncol 29(1):25\u201327. https:\/\/doi.org\/10.1245\/s10434-021-10792-7","journal-title":"Ann Surg Oncol"},{"issue":"1","key":"7829_CR53","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-023-36282-2","volume":"13","author":"AM Hassan","year":"2023","unstructured":"Hassan AM, Chu CK, Liu J et al (2023) A nationwide cross-sectional study on the association of patient-level factors with financial anxiety in the context of chronic medical conditions. Sci Rep 13(1):10363. https:\/\/doi.org\/10.1038\/s41598-023-36282-2","journal-title":"Sci Rep"},{"key":"7829_CR54","unstructured":"Services CfMaM. Lymphedema Compression Treatment Items https:\/\/www.cms.gov\/medicare\/payment\/fee-schedules\/dmepos-fee-schedule\/lymphedema-compression-treatment-items"},{"issue":"6","key":"7829_CR55","doi-asserted-by":"publisher","first-page":"1284","DOI":"10.1002\/cncr.34048","volume":"128","author":"NL Berlin","year":"2022","unstructured":"Berlin NL, Abrahamse P, Momoh AO et al (2022) Perceived financial decline related to breast reconstruction following mastectomy in a diverse population-based cohort. Cancer 128(6):1284\u20131293. https:\/\/doi.org\/10.1002\/cncr.34048","journal-title":"Cancer"},{"issue":"9","key":"7829_CR56","doi-asserted-by":"publisher","first-page":"7665","DOI":"10.1007\/s00520-022-07204-1","volume":"30","author":"AM Hassan","year":"2022","unstructured":"Hassan AM, Chu CK, Liu J, Angove R, Rocque G, Gallagher KD, Momoh AO, Caston NE, Williams CP, Wheeler S, Butler CE, Offodile AC (2022) Determinants of telemedicine adoption among financially distressed patients with cancer during the COVID-19 pandemic: insights from a nationwide study. Support Care Cancer 30(9):7665\u20137678. https:\/\/doi.org\/10.1007\/s00520-022-07204-1","journal-title":"Support Care Cancer"}],"container-title":["Breast Cancer Research and Treatment"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s10549-025-07829-w.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s10549-025-07829-w","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s10549-025-07829-w.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,1,7]],"date-time":"2026-01-07T12:38:52Z","timestamp":1767789532000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s10549-025-07829-w"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,11,20]]},"references-count":56,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2026,1]]}},"alternative-id":["7829"],"URL":"https:\/\/doi.org\/10.1007\/s10549-025-07829-w","relation":{},"ISSN":["0167-6806","1573-7217"],"issn-type":[{"value":"0167-6806","type":"print"},{"value":"1573-7217","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,11,20]]},"assertion":[{"value":"29 July 2025","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"11 November 2025","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"20 November 2025","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The authors have no financial interests to declare in relation to the content of this article.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}}],"article-number":"1"}}