Multimodal treatments and the risk of breast cancer-related lymphedema: insights from a nationally representative cohort in South Korea

Abstract Background As the roles of chemotherapy (Chemo) and radiation therapy (Radio) in the definitive treatment of breast cancer have expanded, a broader understanding of the factors associated with breast cancer-related lymphedema (BCRL) has become increasingly essential. Therefore, we investiga...

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Main Authors: Sung Hoon Jeong, Seong Min Chun, Miji Kim, Ye Seol Lee, Jisun Kim, Ja-Ho Leigh, Yoon-Hee Choi
Format: Article
Language:English
Published: BMC 2025-01-01
Series:BMC Cancer
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Online Access:https://doi.org/10.1186/s12885-025-13513-5
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author Sung Hoon Jeong
Seong Min Chun
Miji Kim
Ye Seol Lee
Jisun Kim
Ja-Ho Leigh
Yoon-Hee Choi
author_facet Sung Hoon Jeong
Seong Min Chun
Miji Kim
Ye Seol Lee
Jisun Kim
Ja-Ho Leigh
Yoon-Hee Choi
author_sort Sung Hoon Jeong
collection DOAJ
description Abstract Background As the roles of chemotherapy (Chemo) and radiation therapy (Radio) in the definitive treatment of breast cancer have expanded, a broader understanding of the factors associated with breast cancer-related lymphedema (BCRL) has become increasingly essential. Therefore, we investigated the association between multimodality treatment and the risk of BCRL. Methods In this retrospective study conducted using National Health Insurance data and the Korea National Cancer Incidence Database (2006–2017), 114,638 participants who underwent Surgery (Surg) or Chemo within 6 months after breast cancer diagnosis were enrolled, and the effect of multimodality treatment on the risk of BCRL was analyzed using the Cox proportional-hazards model. Multimodality treatment administered through six months of treatment was grouped as only Surg; Surg/Chemo; Surg/ Chemo/Radio; Surg/Radio; only Chemo; and Chemo/Radio. Results The risk of BCRL was higher in the Surg/Chemo group (hazard ratio [HR]: 1.54, 95% confidence interval [CI]: 1.43–1.65), Surg/Chemo/Radio group (HR: 1.51, 95% CI: 1.43–1.65), only Chemo group (HR: 1.58, 95% CI: 1.45–1.71), and Chemo/Radio group (HR: 1.13, 95% CI: 1.00–1.29) in comparison with the only Surg group. Conclusion BCRL occurrence is an after-effect of complex breast cancer treatments, and the risk may vary depending on the treatment method, including Surg, chemo, and radio. Our findings suggest that multidisciplinary strategies are required to minimize the risk of BCRL development in patients with breast cancer.
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spelling doaj-art-9fd05199ca164163addeba7d3cc276c12025-01-26T12:37:53ZengBMCBMC Cancer1471-24072025-01-0125111210.1186/s12885-025-13513-5Multimodal treatments and the risk of breast cancer-related lymphedema: insights from a nationally representative cohort in South KoreaSung Hoon Jeong0Seong Min Chun1Miji Kim2Ye Seol Lee3Jisun Kim4Ja-Ho Leigh5Yoon-Hee Choi6Department of Rehabilitation Medicine, Seoul National University HospitalDepartment of Physical Medicine and Rehabilitation, Soonchunhyang University Hospital Seoul, Soonchunhyang University College of MedicineDepartment of Biostatistics and Computing, Yonsei University Graduate SchoolDepartment of Long-term Care Benefits, National Health Insurance ServiceDepartment of Surgery, Asan Medical Center, University of Ulsan College of MedicineDepartment of Rehabilitation Medicine, Seoul National University HospitalDepartment of Physical Medicine and Rehabilitation, Soonchunhyang University Hospital Seoul, Soonchunhyang University College of MedicineAbstract Background As the roles of chemotherapy (Chemo) and radiation therapy (Radio) in the definitive treatment of breast cancer have expanded, a broader understanding of the factors associated with breast cancer-related lymphedema (BCRL) has become increasingly essential. Therefore, we investigated the association between multimodality treatment and the risk of BCRL. Methods In this retrospective study conducted using National Health Insurance data and the Korea National Cancer Incidence Database (2006–2017), 114,638 participants who underwent Surgery (Surg) or Chemo within 6 months after breast cancer diagnosis were enrolled, and the effect of multimodality treatment on the risk of BCRL was analyzed using the Cox proportional-hazards model. Multimodality treatment administered through six months of treatment was grouped as only Surg; Surg/Chemo; Surg/ Chemo/Radio; Surg/Radio; only Chemo; and Chemo/Radio. Results The risk of BCRL was higher in the Surg/Chemo group (hazard ratio [HR]: 1.54, 95% confidence interval [CI]: 1.43–1.65), Surg/Chemo/Radio group (HR: 1.51, 95% CI: 1.43–1.65), only Chemo group (HR: 1.58, 95% CI: 1.45–1.71), and Chemo/Radio group (HR: 1.13, 95% CI: 1.00–1.29) in comparison with the only Surg group. Conclusion BCRL occurrence is an after-effect of complex breast cancer treatments, and the risk may vary depending on the treatment method, including Surg, chemo, and radio. Our findings suggest that multidisciplinary strategies are required to minimize the risk of BCRL development in patients with breast cancer.https://doi.org/10.1186/s12885-025-13513-5Breast cancerRisk of breast cancer-related lymphedemaMultimodality treatmentEpidemiology
spellingShingle Sung Hoon Jeong
Seong Min Chun
Miji Kim
Ye Seol Lee
Jisun Kim
Ja-Ho Leigh
Yoon-Hee Choi
Multimodal treatments and the risk of breast cancer-related lymphedema: insights from a nationally representative cohort in South Korea
BMC Cancer
Breast cancer
Risk of breast cancer-related lymphedema
Multimodality treatment
Epidemiology
title Multimodal treatments and the risk of breast cancer-related lymphedema: insights from a nationally representative cohort in South Korea
title_full Multimodal treatments and the risk of breast cancer-related lymphedema: insights from a nationally representative cohort in South Korea
title_fullStr Multimodal treatments and the risk of breast cancer-related lymphedema: insights from a nationally representative cohort in South Korea
title_full_unstemmed Multimodal treatments and the risk of breast cancer-related lymphedema: insights from a nationally representative cohort in South Korea
title_short Multimodal treatments and the risk of breast cancer-related lymphedema: insights from a nationally representative cohort in South Korea
title_sort multimodal treatments and the risk of breast cancer related lymphedema insights from a nationally representative cohort in south korea
topic Breast cancer
Risk of breast cancer-related lymphedema
Multimodality treatment
Epidemiology
url https://doi.org/10.1186/s12885-025-13513-5
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