Race or Resource? BMI, Race, and Other Social Factors as Risk Factors for Interlimb Differences among Overweight Breast Cancer Survivors with Lymphedema

Lorraine T. Dean, Anagha Kumar, Taehoon Kim, Matthew Herling, Justin C. Brown, Zi Zhang, Margaret Evangelisti, Renata Hackley, Jiyoung Kim, Andrea L Cheville, Andrea B. Troxel, J. Sanford Schwartz, Kathryn H. Schmitz

Research output: Contribution to journalArticle

4 Citations (Scopus)

Abstract

Introduction. High BMI is a risk factor for upper body breast cancer-related lymphedema (BCRL) onset. Black cancer survivors are more likely to have high BMI than White cancer survivors. While observational analyses suggest up to 2.2 times increased risk of BCRL onset for Black breast cancer survivors, no studies have explored race or other social factors that may affect BCRL severity, operationalized by interlimb volume difference (ILD). Materials and Methods. ILD was measured by perometry for 296 overweight (25 > BMI < 50) Black (n = 102) or White (n = 194) breast cancer survivors (>6 months from treatment) in the WISER Survivor trial. Multivariable linear regression examined associations between social and physical factors and ILD. Results. Neither Black race (-0.26, p = 0.89) nor BMI (0.22, p = 0.10) was associated with ILD. Attending college (-4.89, p = 0.03) was the strongest factor associated with ILD, followed by having more lymph nodes removed (4.75, p = 0.01), >25% BCRL care adherence (4.10, p = 0.01), and years since treatment (0.55, p < 0.001). Discussion. Neither race nor BMI was associated with ILD among overweight cancer survivors. Education, a proxy for resource level, was the strongest factor associated with greater ILD. Tailoring physical activity and weight loss interventions designed to address BCRL severity by resource rather than race should be considered.

Original languageEnglish (US)
Article number8241710
JournalJournal of Obesity
Volume2016
DOIs
StatePublished - 2016

Fingerprint

Lymphedema
Survivors
Breast Neoplasms
Neoplasms
Proxy
Weight Loss
Linear Models
Lymph Nodes
Breast Cancer Lymphedema
Exercise
Education
Therapeutics

ASJC Scopus subject areas

  • Endocrinology, Diabetes and Metabolism

Cite this

Race or Resource? BMI, Race, and Other Social Factors as Risk Factors for Interlimb Differences among Overweight Breast Cancer Survivors with Lymphedema. / Dean, Lorraine T.; Kumar, Anagha; Kim, Taehoon; Herling, Matthew; Brown, Justin C.; Zhang, Zi; Evangelisti, Margaret; Hackley, Renata; Kim, Jiyoung; Cheville, Andrea L; Troxel, Andrea B.; Schwartz, J. Sanford; Schmitz, Kathryn H.

In: Journal of Obesity, Vol. 2016, 8241710, 2016.

Research output: Contribution to journalArticle

Dean, LT, Kumar, A, Kim, T, Herling, M, Brown, JC, Zhang, Z, Evangelisti, M, Hackley, R, Kim, J, Cheville, AL, Troxel, AB, Schwartz, JS & Schmitz, KH 2016, 'Race or Resource? BMI, Race, and Other Social Factors as Risk Factors for Interlimb Differences among Overweight Breast Cancer Survivors with Lymphedema', Journal of Obesity, vol. 2016, 8241710. https://doi.org/10.1155/2016/8241710
Dean, Lorraine T. ; Kumar, Anagha ; Kim, Taehoon ; Herling, Matthew ; Brown, Justin C. ; Zhang, Zi ; Evangelisti, Margaret ; Hackley, Renata ; Kim, Jiyoung ; Cheville, Andrea L ; Troxel, Andrea B. ; Schwartz, J. Sanford ; Schmitz, Kathryn H. / Race or Resource? BMI, Race, and Other Social Factors as Risk Factors for Interlimb Differences among Overweight Breast Cancer Survivors with Lymphedema. In: Journal of Obesity. 2016 ; Vol. 2016.
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abstract = "Introduction. High BMI is a risk factor for upper body breast cancer-related lymphedema (BCRL) onset. Black cancer survivors are more likely to have high BMI than White cancer survivors. While observational analyses suggest up to 2.2 times increased risk of BCRL onset for Black breast cancer survivors, no studies have explored race or other social factors that may affect BCRL severity, operationalized by interlimb volume difference (ILD). Materials and Methods. ILD was measured by perometry for 296 overweight (25 > BMI < 50) Black (n = 102) or White (n = 194) breast cancer survivors (>6 months from treatment) in the WISER Survivor trial. Multivariable linear regression examined associations between social and physical factors and ILD. Results. Neither Black race (-0.26, p = 0.89) nor BMI (0.22, p = 0.10) was associated with ILD. Attending college (-4.89, p = 0.03) was the strongest factor associated with ILD, followed by having more lymph nodes removed (4.75, p = 0.01), >25{\%} BCRL care adherence (4.10, p = 0.01), and years since treatment (0.55, p < 0.001). Discussion. Neither race nor BMI was associated with ILD among overweight cancer survivors. Education, a proxy for resource level, was the strongest factor associated with greater ILD. Tailoring physical activity and weight loss interventions designed to address BCRL severity by resource rather than race should be considered.",
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AU - Dean, Lorraine T.

AU - Kumar, Anagha

AU - Kim, Taehoon

AU - Herling, Matthew

AU - Brown, Justin C.

AU - Zhang, Zi

AU - Evangelisti, Margaret

AU - Hackley, Renata

AU - Kim, Jiyoung

AU - Cheville, Andrea L

AU - Troxel, Andrea B.

AU - Schwartz, J. Sanford

AU - Schmitz, Kathryn H.

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N2 - Introduction. High BMI is a risk factor for upper body breast cancer-related lymphedema (BCRL) onset. Black cancer survivors are more likely to have high BMI than White cancer survivors. While observational analyses suggest up to 2.2 times increased risk of BCRL onset for Black breast cancer survivors, no studies have explored race or other social factors that may affect BCRL severity, operationalized by interlimb volume difference (ILD). Materials and Methods. ILD was measured by perometry for 296 overweight (25 > BMI < 50) Black (n = 102) or White (n = 194) breast cancer survivors (>6 months from treatment) in the WISER Survivor trial. Multivariable linear regression examined associations between social and physical factors and ILD. Results. Neither Black race (-0.26, p = 0.89) nor BMI (0.22, p = 0.10) was associated with ILD. Attending college (-4.89, p = 0.03) was the strongest factor associated with ILD, followed by having more lymph nodes removed (4.75, p = 0.01), >25% BCRL care adherence (4.10, p = 0.01), and years since treatment (0.55, p < 0.001). Discussion. Neither race nor BMI was associated with ILD among overweight cancer survivors. Education, a proxy for resource level, was the strongest factor associated with greater ILD. Tailoring physical activity and weight loss interventions designed to address BCRL severity by resource rather than race should be considered.

AB - Introduction. High BMI is a risk factor for upper body breast cancer-related lymphedema (BCRL) onset. Black cancer survivors are more likely to have high BMI than White cancer survivors. While observational analyses suggest up to 2.2 times increased risk of BCRL onset for Black breast cancer survivors, no studies have explored race or other social factors that may affect BCRL severity, operationalized by interlimb volume difference (ILD). Materials and Methods. ILD was measured by perometry for 296 overweight (25 > BMI < 50) Black (n = 102) or White (n = 194) breast cancer survivors (>6 months from treatment) in the WISER Survivor trial. Multivariable linear regression examined associations between social and physical factors and ILD. Results. Neither Black race (-0.26, p = 0.89) nor BMI (0.22, p = 0.10) was associated with ILD. Attending college (-4.89, p = 0.03) was the strongest factor associated with ILD, followed by having more lymph nodes removed (4.75, p = 0.01), >25% BCRL care adherence (4.10, p = 0.01), and years since treatment (0.55, p < 0.001). Discussion. Neither race nor BMI was associated with ILD among overweight cancer survivors. Education, a proxy for resource level, was the strongest factor associated with greater ILD. Tailoring physical activity and weight loss interventions designed to address BCRL severity by resource rather than race should be considered.

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