Abstract
The disparity among breast cancer survivors who do and do not develop secondary lymphedema has remained a perplexing paradox. Many factors have been identified to be unrelated to the development of this complication, yet it remains difficult to prospectively identify those who are definitively at risk for the ultimate development of a lymphatic complication of cancer therapy.
In this issue of Lymphatic Research and Biology, Leray and colleagues publish an article that summarizes their investigation of aspects of this question, through a retrospective analysis of an appropriate cohort of their patients. In their investigation, the clinical characteristics of the patients and the associated factors related to the severity of breast cancer-related lymphedema were investigated. Although there was no significant association between LE severity and treatments received for breast cancer, the authors observed that body mass index at the time of the lymphedema diagnosis was the sole variable that was significantly associated with the presence of severe lymphedema.
Although the link between breast cancer and obesity is well established,1,2 as is the relationship between obesity and the development of lymphedema,3,4 the study of Leray and colleagues underscores the importance of the body mass index in determining the severity of lymphedema in the setting of breast cancer treatment. As the authors emphasize, these observations underscore the importance of weight maintenance during cancer diagnosis and therapy, and the fact that patient education must be central to this process.