Epidemiological and Clinical Risk Factors for Breast Cancer-Related Lymphedema: A Case-Control Study From Hamadan, Western Iran

Abstract

BACKGROUND: Breast cancer-related lymphedema (BCRL) is one of main issues following treatments in patients with breast cancer (BC). The current study is aimed at evaluating epidemiological and clinical risk factors for BCRL in female patients with BC. METHODS: In a case-control study design from October 2024 to March 2025, female BC patients with and without BCRL were recruited from the Lymphedema Physiotherapy Clinic and the Cancer Therapeutic and Diagnosis Imaging Center in Hamadan, Western Iran. Patient, tumor, and treatment characteristics were gathered via interview and reviewing medical and pathology records. RESULTS: Overall, 230 patients (127 cases and 103 controls) were included. The multivariable analysis revealed several potential risk factors for BCRL: older age at diagnosis (odds ratio OR = 1.05; 95% confidence interval CI, 1.00, 1.10), urban residency (4.76; 1.20, 20.00), axillary lymph node dissection number of 6-9 compared to </= 5 (2.54; 0.99, 6.49), pathology grade of 2 (7.11; 1.47, 34.27) and 3 (6.53; 1.32, 32.32) compared to Grade 1, mastectomy versus lumpectomy (2.86; 1.23, 6.67), receiving chemotherapy (9.55; 1.23, 73.95), and positive progesterone receptor (PR) status (2.56; 1.16, 5.55). CONCLUSION: The combination of patient, tumor, and treatment characteristics may be associated with BCRL, highlighting the close monitoring of high-risk patients (older age, high-grade tumors, mastectomy, and PR-positive) in Western Iran.