The impact of obesity on the outcomes of complex decongestive therapy among patients with breast cancer-related lymphedema.

Abstract

Objectives: This study aims to evaluate the influence of complex decongestive therapy (CDT) on patients with breast cancer-related lymphedema (BCRL) in terms of reducing volume, improving functional capabilities, and enhancing the quality of life and analyze the effect of obesity on their recovery process.

Patients and methods: This retrospective study was conducted between January 2018 and March 2020. The investigation comprised individuals with unilateral BCRL who received CDT during the previous year. The participants were split into two classifications: those with a normal or overweight status (Group 1) and those classified as obese or morbidly obese (Group 2). Each participant engaged in CDT sessions five times weekly for three weeks. The groups were compared regarding their functional status and quality of life scores as measured by the Quick Disabilities of the Arm, Shoulder, and Hand and Lymphedema Quality of Life (LYMQOL)-Arm questionnaires.

Results: This study included 81 female patients (mean age: 53.6±10.4 years; range, 28 to 87 years) with BCRL. Half of the participants were identified as obese and the mean body mass index (BMI) was 30.32±4.63 kg/m² . The median lymphedema duration was 12 months. After treatment, there was a notable reduction in both the mean initial limb volume and excess volumes (3183±681 cm³ vs. 2912±599 cm³ and 30.1% vs. 19.3%, respectively; p<0.001). Both groups showed substantial and similar enhancements in volumes, functional scores, and all subscores of the LYMQOL-Arm questionnaire following CDT. When the patients with a BMI below and above 30 were compared, the improvement in function and appearance scores of LYMQOL-Arm was substantially distinct between the two categories. We also indicated a substantial negative relationship between the enhancement of LYMQOL-Arm function and appearance subscores and BMI (p=0.005, r=-0.486 and p=0.042, r=-0.361).

Conclusion: The influence of CDT on decreasing volume and improving functionality was comparable between obese and nonobese patients with BCRL; however, obesity may negatively impact CDT outcomes concerning quality of life issues.