- Background
Lymphedema and seroma are common complications following breast cancer (BC) surgery. Lymphedema is defined as lymphatic congestion due to a damaged lymphatic system. Diagnosis is challenging and often protracted, treatment is tedious and therapeutic or preventive options are limited. Meanwhile, seroma is a fluid accumulation of unknown origin developing shortly after BC surgery. Despite the prevalence of both conditions, their pathophysiological relationship remains poorly understood. Hence, this study aims to investigate co-occurrence of lymphedema and seroma in BC patients following local treatment.
Methods
BC-related lymphedema and seroma formation have been assessed in patients undergoing surgical BC treatment via a self-developed questionnaire (n=332). Patients were asked to indicate whether lymphedema and seroma have been diagnosed by physicians or self-perceived. Besides, patients were asked to specify the affected body part.
Results
Lymphedema reports were moreBackground
Lymphedema and seroma are common complications following breast cancer (BC) surgery. Lymphedema is defined as lymphatic congestion due to a damaged lymphatic system. Diagnosis is challenging and often protracted, treatment is tedious and therapeutic or preventive options are limited. Meanwhile, seroma is a fluid accumulation of unknown origin developing shortly after BC surgery. Despite the prevalence of both conditions, their pathophysiological relationship remains poorly understood. Hence, this study aims to investigate co-occurrence of lymphedema and seroma in BC patients following local treatment.
Methods
BC-related lymphedema and seroma formation have been assessed in patients undergoing surgical BC treatment via a self-developed questionnaire (n=332). Patients were asked to indicate whether lymphedema and seroma have been diagnosed by physicians or self-perceived. Besides, patients were asked to specify the affected body part.
Results
Lymphedema reports were more common among patients reporting seroma than patients without seroma reports (59.5% vs. 11.7%, p<0.001). Binary logistic regression analysis confirmed that, in a multivariate analysis, patient-reported seroma was associated with the highest odds of patient-reported lymphedema (OR 7.964, p<0.001). Additionally, lymphedema localization depended significantly on the seroma region (p<0.001), regarding axillary and breast seroma.
Conclusions
Our findings suggest that seroma may be a relevant risk factor for lymphedema formation in BC patients. As this analysis relies on patient-reported outcomes, potential biases must be considered. In order to reduce this risk, patient-friendly definitions were provided, and additional sensitivity analyses using only physician-diagnosed reports were performed. This confirms the robustness of the study and indicates minimal misconception in the nearly 60%-overlap of seroma patients reporting lymphedema. Further research should focus on identifying potential pathophysiological parallels or differences.…
