{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T16:04:36Z","timestamp":1791475476087,"version":"4.3.4"},"reference-count":31,"publisher":"MDPI AG","issue":"3","license":[{"start":{"date-parts":[[2015,9,3]],"date-time":"2015-09-03T00:00:00Z","timestamp":1441238400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JPM"],"abstract":"<jats:p>Obesity is one of the risk factors for developing lymphedema following breast cancer treatment. We prospectively enrolled 140 women and followed the participants for 12 months after surgery to investigate patterns of obesity and lymph fluid level in the first year of cancer treatment. Electrical bioimpedance devices were used to measure weight, BMI, and percent of body fat as well as lymph fluid level. General instructions were given to the participants on maintaining pre-surgery weight. Among the 140 participants, 136 completed the study with 2.9% attrition. More than 60% of the participants were obese (30.8%) or overweight (32.4%), while only two participants were underweight and about 35% had normal weight. This pattern of obesity and overweight was consistent at 4\u20138 weeks and 12 months post-surgery. At 12 months post-surgery, the majority of the women (72.1%) maintained pre-surgery weight and 15.4% had &gt;5% weight loss; 12.5% of the women increase &gt;5% of their weight. Significantly more patients in the obesity group had lymphedema defined by L-Dex ratio &gt;7.1 than those in the normal\/underweight and overweight group at pre-surgery and 4\u20138 weeks post-surgery. There was a trend of more patients in the obesity group had L-Dex ratio &gt;7.1 at 12 months post-surgery. Obesity and overweight remain among women at the time of cancer diagnosis and the patterns of obesity and overweight continue during the first year of treatment. General instructions on having nutrition-balanced and portion-appropriate diet and physical activities daily or weekly can be effective to maintain pre-surgery weight.<\/jats:p>","DOI":"10.3390\/jpm5030326","type":"journal-article","created":{"date-parts":[[2015,9,3]],"date-time":"2015-09-03T10:57:07Z","timestamp":1441277827000},"page":"326-340","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":38,"title":["Patterns of Obesity and Lymph Fluid Level during the First Year of Breast Cancer Treatment: A Prospective Study"],"prefix":"10.3390","volume":"5","author":[{"given":"Mei","family":"Fu","sequence":"first","affiliation":[{"name":"College of Nursing, New York University, 433 First Avenue, New York, NY 10010, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Deborah","family":"Axelrod","sequence":"additional","affiliation":[{"name":"Department of Surgery, School of Medicine, New York University, 160 East 34 Street, New York, NY 10016, USA"},{"name":"NYU Laura and Isaac Perlmutter Cancer Center, 160 East 34 Street, New York, NY 10016, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amber","family":"Guth","sequence":"additional","affiliation":[{"name":"Department of Surgery, School of Medicine, New York University, 160 East 34 Street, New York, NY 10016, USA"},{"name":"NYU Laura and Isaac Perlmutter Cancer Center, 160 East 34 Street, New York, NY 10016, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jason","family":"Fletcher","sequence":"additional","affiliation":[{"name":"College of Nursing, New York University, 433 First Avenue, New York, NY 10010, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeanna","family":"Qiu","sequence":"additional","affiliation":[{"name":"College of Nursing, New York University, 433 First Avenue, New York, NY 10010, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joan","family":"Scagliola","sequence":"additional","affiliation":[{"name":"NYU Laura and Isaac Perlmutter Cancer Center, 160 East 34 Street, New York, NY 10016, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robin","family":"Kleinman","sequence":"additional","affiliation":[{"name":"NYU Laura and Isaac Perlmutter Cancer Center, 160 East 34 Street, New York, NY 10016, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Caitlin","family":"Ryan","sequence":"additional","affiliation":[{"name":"College of Nursing, New York University, 433 First Avenue, New York, NY 10010, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicholas","family":"Chan","sequence":"additional","affiliation":[{"name":"College of Nursing, New York University, 433 First Avenue, New York, NY 10010, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Judith","family":"Haber","sequence":"additional","affiliation":[{"name":"College of Nursing, New York University, 433 First Avenue, New York, NY 10010, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2015,9,3]]},"reference":[{"key":"ref_1","unstructured":"World Health Organization Obesity and overweight fact sheet N\u00b0311 updated August 2014. Available online:http:\/\/www.who.int\/mediacentre\/factsheets\/fs311\/en\/."},{"key":"ref_2","first-page":"69","article-title":"Global cancer statistics","volume":"61","author":"Jemal","year":"2011","journal-title":"Cancer J."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"1901","DOI":"10.1093\/annonc\/mdu042","article-title":"Body mass index and survival in women with breast cancer\u2014Systematic review and meta-analysis of 82 follow-up studies","volume":"25","author":"Chan","year":"2014","journal-title":"Ann. Oncol."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"538","DOI":"10.1080\/01635581.2011.539316","article-title":"Weight change and its correlates among breast cancer survivors","volume":"63","author":"Chen","year":"2011","journal-title":"Nutr. Cancer"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"823","DOI":"10.1007\/s10549-009-0708-3","article-title":"Obesity and weight change in relation to breast cancer survival","volume":"122","author":"Chen","year":"2010","journal-title":"Breast Cancer Res. Treat."},{"key":"ref_6","unstructured":"American Cancer Society (2013). Breast Cancer Facts and Figures 2013\u20132014, American Cancer Society."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"68","DOI":"10.1188\/14.CJON.S3.68-79","article-title":"Cancer-related lymphedema: Evolving evidence for treatment and management from 2009 to 2014","volume":"S18","author":"Fu","year":"2014","journal-title":"Clin. J. Oncol. Nurs."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"5213","DOI":"10.1200\/JCO.2008.16.3725","article-title":"Prevalence of lymphedema in women with breast cancer 5 years after sentinel lymph node biopsy or axillary dissection: Objective measurements","volume":"26","author":"McLaughlin","year":"2008","journal-title":"J. Clin. Oncol."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"775","DOI":"10.1158\/1055-9965.EPI-06-0168","article-title":"The epidemiology of arm and hand swelling in premenopausal breast cancer survivors","volume":"16","author":"Paskett","year":"2007","journal-title":"Cancer Epidemiol. Biomarkers Prev."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"1368","DOI":"10.1002\/1097-0142(20010915)92:6<1368::AID-CNCR1459>3.0.CO;2-9","article-title":"Lymphedema in a cohort of breast carcinoma survivors 20 years after diagnosis","volume":"92","author":"Petrek","year":"2001","journal-title":"Cancer"},{"key":"ref_11","first-page":"241","article-title":"Breast cancer-related lymphedema: Symptoms, diagnosis, risk reduction, and management","volume":"5","author":"Fu","year":"2014","journal-title":"J. Clin. Oncol."},{"key":"ref_12","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_13","doi-asserted-by":"crossref","first-page":"1959","DOI":"10.1245\/s10434-009-0452-2","article-title":"The risk of developing arm lymphedema among breast cancer survivors: A meta-analysis of treatment factors","volume":"16","author":"Tsai","year":"2009","journal-title":"Ann. Surg. Oncol."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"2734","DOI":"10.1158\/1055-9965.EPI-09-1245","article-title":"Risk factors for lymphedema after breast cancer treatment","volume":"19","author":"Norman","year":"2010","journal-title":"Cancer Epidemiol. Biomarkers Prev."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"578","DOI":"10.1111\/j.1440-1673.2006.01658.x","article-title":"Supraclavicular radiotherapy must be limited laterally by the coracoid to avoid significant adjuvant breast nodal radiotherapy lymphoedema risk","volume":"50","author":"Graham","year":"2006","journal-title":"Australas. Radiol."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"2007","DOI":"10.1200\/JCO.2008.18.3517","article-title":"Incidence, treatment costs, and complications of lymphedema after breast cancer among women of working age: A 2-year follow-up study","volume":"27","author":"Shih","year":"2009","journal-title":"J. Clin. Oncol."},{"key":"ref_17","first-page":"161","article-title":"Minimal limb volume change has a significant impact on breast cancer survivors","volume":"42","author":"Cormier","year":"2009","journal-title":"Lymphology"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"853","DOI":"10.1007\/s00520-011-1089-9","article-title":"Body mass index and breast cancer treatment-related lymphedema","volume":"19","author":"Ridner","year":"2011","journal-title":"Support. Care Cancer"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"1055","DOI":"10.1001\/archsurg.2010.231","article-title":"Risk factors for lymphedema in a prospective breast cancer survivorship study: The pathways study","volume":"145","author":"Kwan","year":"2010","journal-title":"Arch. Surg."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"48","DOI":"10.1111\/j.1524-4741.2009.00855.x","article-title":"Obesity is a risk factor for developing postoperative lymphedema in breast cancer patients","volume":"16","author":"Helyer","year":"2010","journal-title":"Breast J."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"59","DOI":"10.1007\/s10549-013-2715-7","article-title":"Impact of body mass index and weight fluctuation on lymphedema risk in patients treated for breast cancer","volume":"142","author":"Jammallo","year":"2013","journal-title":"Breast Cancer Res. Treat."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"3278","DOI":"10.1245\/s10434-010-1155-4","article-title":"Morbidity of sentinel node biopsy in breast cancer: The relationship between the number of excised lymph nodes and lymphedema","volume":"17","author":"Goldberg","year":"2010","journal-title":"Ann. Surg. Oncol."},{"key":"ref_23","first-page":"85","article-title":"L-Dex ratio in detecting breast cancer-related lymphedema: Reliability, sensitivity, and specificity","volume":"46","author":"Fu","year":"2013","journal-title":"Lymphology"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"3481","DOI":"10.1245\/s10434-014-3761-z","article-title":"Proactive approach to lymphedema risk reduction: A prospective study","volume":"21","author":"Fu","year":"2014","journal-title":"Ann. Surg. Oncol."},{"key":"ref_25","first-page":"1535","article-title":"Pattern of weight changes in women with breast cancer","volume":"11","author":"Yaw","year":"2010","journal-title":"Asian Pac. J. Cancer Prev."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"2277","DOI":"10.1002\/cncr.27466","article-title":"Weight management and its role in breast cancer rehabilitation","volume":"118","author":"Campbell","year":"2012","journal-title":"Cancer"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"2506","DOI":"10.1093\/annonc\/mdt224","article-title":"Obesity, diabetes, and survival outcomes in a large cohort of early-stage breast cancer patients","volume":"24","author":"Jiralerspong","year":"2013","journal-title":"Ann. Oncol."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"272","DOI":"10.5306\/wjco.v5.i3.272","article-title":"Weight gain following breast cancer diagnosis: Implication and proposed mechanisms","volume":"5","author":"Braun","year":"2014","journal-title":"World J. Clin. Oncol."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"621","DOI":"10.1007\/s10552-009-9491-z","article-title":"Weight change patterns among breast cancer survivors: Results from the Shanghai breast cancer survival study","volume":"21","author":"Gu","year":"2013","journal-title":"Cancer Causes Control"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"774","DOI":"10.1200\/JCO.2005.04.036","article-title":"Changes in body fat and weight after a breast cancer diagnosis: Influence of demographic, prognostic, and lifestyle factors","volume":"23","author":"Irwin","year":"2005","journal-title":"J. Clin. Oncol."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"105","DOI":"10.3892\/mco.2013.209","article-title":"Body weight changes in breast cancer patients following adjuvant chemotherapy and contributing factors","volume":"2","author":"Wang","year":"2014","journal-title":"Mol. Clin. Oncol."}],"container-title":["Journal of Personalized Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2075-4426\/5\/3\/326\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T20:48:00Z","timestamp":1760215680000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2075-4426\/5\/3\/326"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2015,9,3]]},"references-count":31,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2015,9]]}},"alternative-id":["jpm5030326"],"URL":"https:\/\/doi.org\/10.3390\/jpm5030326","relation":{},"ISSN":["2075-4426"],"issn-type":[{"value":"2075-4426","type":"electronic"}],"subject":[],"published":{"date-parts":[[2015,9,3]]}}}