{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,19]],"date-time":"2026-05-19T14:21:13Z","timestamp":1779200473925,"version":"3.51.4"},"reference-count":56,"publisher":"MDPI AG","issue":"14","license":[{"start":{"date-parts":[[2021,7,17]],"date-time":"2021-07-17T00:00:00Z","timestamp":1626480000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cancers"],"abstract":"<jats:p>Cellulitis is a common complication in Breast Cancer-Related Lymphedema (BCRL). The excess amount of fat and lean mass in BCRL is a vital factor in patient stratification, prognosis, and treatments. However, it is not known whether cellulitis is associated with the excess fat and lean mass in BCRL. Therefore, this prospective observational study was designed to fundamentally understand the heterogonous biocomposition of BCRL. For this study, we consecutively enrolled 206 patients with unilateral BCRL between January 2019 and February 2020. All patients underwent Dual-Energy X-Ray Absorptiometry scans, bioimpedance spectroscopy, indocyanine green lymphangiography comprehensive history of potential risk factors, and a clinical exam. Multivariate linear and beta regression models were used to determine the strength of association and margins effect. Sixty-nine patients (33%) had at least one previous episode of cellulitis. Notably, a previous episode of cellulitis was associated with 20 percentage points more excess fat and 10 percentage points more excess lean mass compared to patients without cellulitis (p &lt; 0.05). Moreover, each 1 increase in the patients BMI was associated with a 0.03 unit increase in the fat mass proportion of the lymphedema arm. Cellulitis was associated with more excess fat and lean arm mass in BCRL. In addition, patients BMI affect the proportion of fat mass in the arm.<\/jats:p>","DOI":"10.3390\/cancers13143584","type":"journal-article","created":{"date-parts":[[2021,7,18]],"date-time":"2021-07-18T21:16:48Z","timestamp":1626643008000},"page":"3584","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":13,"title":["Cellulitis Is Associated with Severe Breast Cancer-Related Lymphedema: An Observational Study of Tissue Composition"],"prefix":"10.3390","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8755-3446","authenticated-orcid":false,"given":"Mads Gustaf","family":"J\u00f8rgensen","sequence":"first","affiliation":[{"name":"Department of Plastic Surgery, Odense University Hospital, 5000 Odense, Denmark"},{"name":"Clinical Institute, University of Southern Denmark, 5000 Odense, Denmark"},{"name":"OPEN, Open Patient data Explorative Network, Odense University Hospital, 5000 Odense, Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anne Pernille","family":"Hermann","sequence":"additional","affiliation":[{"name":"Department of Endocrinology, Odense University Hospital, 5000 Odense, Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anette Riis","family":"Madsen","sequence":"additional","affiliation":[{"name":"Department of Endocrinology, Odense University Hospital, 5000 Odense, Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Steffanie","family":"Christensen","sequence":"additional","affiliation":[{"name":"Department of Endocrinology, Odense University Hospital, 5000 Odense, Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6800-4532","authenticated-orcid":false,"given":"Kim Gordon","family":"Ingwersen","sequence":"additional","affiliation":[{"name":"Research Unit in Physiotherapy and Occupational Therapy, University Hospital of Sourthen Denmark\u2014Vejle Hospital, 7100 Vejle, Denmark"},{"name":"Department of Regional Health Research, University of Southern Denmark, 5000 Odense, Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7368-6133","authenticated-orcid":false,"given":"J\u00f8rn Bo","family":"Thomsen","sequence":"additional","affiliation":[{"name":"Department of Plastic Surgery, Odense University Hospital, 5000 Odense, Denmark"},{"name":"Clinical Institute, University of Southern Denmark, 5000 Odense, Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jens Ahm","family":"S\u00f8rensen","sequence":"additional","affiliation":[{"name":"Department of Plastic Surgery, Odense University Hospital, 5000 Odense, Denmark"},{"name":"Clinical Institute, University of Southern Denmark, 5000 Odense, Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2021,7,17]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"500","DOI":"10.1016\/S1470-2045(13)70076-7","article-title":"Incidence of unilateral arm lymphoedema after breast cancer: A systematic review and meta-analysis","volume":"14","author":"DiSipio","year":"2013","journal-title":"Lancet Oncol."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"70","DOI":"10.1038\/s41523-021-00276-y","article-title":"The impact of lymphedema on health-related quality of life up to 10 years after breast cancer treatment","volume":"7","author":"Toyserkani","year":"2021","journal-title":"npj Breast Cancer"},{"key":"ref_3","doi-asserted-by":"crossref","unstructured":"J\u00f8rgensen, M.G., Toyserkani, N.M., Hansen, F.C.G., Thomsen, J.B., and S\u00f8rensen, J.A. 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