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Table 1 Participant characteristics and their associations with lymphedema among 666 female breast cancer survivors

From: Risk factors for self-reported arm lymphedema among female breast cancer survivors: a prospective cohort study

Characteristics Categories N at risk LE (%) HR (95% CI)a HR (95% CI)b
Breast cancer and treatment      
Age at diagnosis (years) 35-44 123 43 (35.0) 1.00 1.00
45-49 128 43 (33.6) 0.98 (0.64 - 1.50) 0.98 (0.63 - 1.52)
50-54 175 46 (26.3) 0.80 (0.52 - 1.21) 0.79 (0.51 - 1.23)
55-59 128 35 (27.3) 0.83 (0.53 - 1.30) 0.78 (0.49 - 1.23)
60-64 112 23 (20.5) 0.59 (0.35 - 0.97) 0.61 (0.35 - 1.06)
Per unit of age    0.98 (0.96 - 1.00) 0.98 (0.96 - 1.00)
    P trend = 0.03 P trend = 0.04
Disease stage In situ 155 15 (9.7) 0.26 (0.15 - 0.45)  
Localized 346 105 (30.4) 1.00  
Regional 165 70 (42.4) 1.35 (0.99 - 1.85)  
Tumor size (mm) <10 178 36 (20.2) 1.00  
10-19 216 66 (30.6) 1.54 (1.02 - 2.32)  
20+ 208 76 (36.5) 1.85 (1.23 - 2.77)  
Missing 64 12 (18.8) 0.80 (0.41 - 1.54)  
Per mm    1.01 (1.00 - 1.02)  
    P trend = 0.02  
Cancer location Nipple, central portion, upper/lower inner quadrant 143 44 (30.8) 1.15 (0.80 - 1.66)  
Upper/lower outer quadrant 292 83 (28.4) 1.00  
Overlapping lesion 147 44 (29.9) 1.07 (0.74 - 1.55)  
Axillary tail, NOS 84 19 (22.6) 0.75 (0.46 - 1.24)  
Surgery type Partial/less than total mastectomy/surgery, NOS 442 108 (24.4) 1.00 1.00
Total mastectomy/modified radical mastectomy 224 82 (36.6) 1.52 (1.13 - 2.04) 1.37 (1.01 - 1.85)
Reconstructive surgery No 533 150 (28.1) 1.00  
Yes 105 33 (31.4) 0.98 (0.67 - 1.45)  
Missing 28 7 (25.0) -  
Number of excised lymph nodes 0 143 9 (6.3) 0.13 (0.06 - 0.25) 0.17 (0.08 - 0.33)
1-9c 162 32 (19.8) 0.44 (0.30 - 0.64) 0.46 (0.31 - 0.68)
10+ 361 149 (41.3) 1.00 1.00
Per lymph node    1.06 (1.04 - 1.08) 1.05 (1.03 - 1.07)
    P trend <0.001 P trend < 0.001
Radiation No 270 73 (27.0) 1.00  
Yes 396 117 (29.6) 1.21 (0.90 - 1.63)  
Chemotherapy No 413 83 (20.1) 1.00 1.00
Yes 253 107 (42.3) 2.28 (1.69 - 3.09) 1.48 (1.09 - 2.02)
Tamoxifen No 382 96 (25.1) 1.00  
Yes 284 94 (33.1) 1.58 (1.18 - 2.12)  
Sociodemographic factors      
Race/ethnicity Non-Hispanic white (NM, WW) 371 88 (23.7) 1.00 1.00
Black (LA) 226 82 (36.3) 1.62 (1.20 - 2.20) 1.16 (0.83 - 1.61)
Hispanic white (NM) 69 20 (29.0) 1.19 (0.73 - 1.94) 1.04 (0.63 - 1.70)
Marital status Married 445 123 (27.6) 1.00  
Widowed 34 10 (29.4) 1.25 (0.64 - 2.43)  
Divorced/separated 140 46 (32.9) 1.20 (0.86 - 1.69)  
Never married 47 11 (23.4) 0.85 (0.45 - 1.58)  
Education High school or less 158 48 (30.4) 1.00  
Some college 249 75 (30.1) 0.92 (0.63 - 1.33)  
College graduate 120 39 (32.5) 1.14 (0.73 - 1.77)  
Graduate studies 139 28 (20.1) 0.65 (0.40 - 1.07)  
Insurance Yes 618 180 (29.1) 1.00  
No 25 8 (32.0) 1.04 (0.51 - 2.12)  
Missing 23 2 (8.7) -  
Health-related factors      
Body mass index prior to diagnosis (kg/m2) <25 306 70 (22.9) 1.00 1.00
25-29.9 220 67 (30.5) 1.40 (0.99 - 1.96) 1.25 (0.88 - 1.76)
30+ 140 53 (37.9) 1.83 (1.27 - 2.63) 1.59 (1.09 - 2.31)
Per unit of BMI    1.04 (1.02 - 1.07) 1.04 (1.01 - 1.06)
    P trend < 0.001 P trend = 0.01
Menopausal statusd Premenopausal 259 82 (31.7) 1.00  
Postmenopausal 341 80 (23.5) 0.81 (0.51 - 1.28)  
Unknown 66 28 (42.4) 1.44 (0.91 - 2.26)  
Hypertension No 468 122 (26.1) 1.00 1.00
Yes 198 68 (34.3) 1.54 (1.11 - 2.12) 1.49 (1.06 - 2.10)
Diabetes No 607 174 (28.7) 1.00  
Yes 59 16 (27.1) 0.96 (0.57 - 1.62)  
Arthritis No 480 135 (28.1) 1.00  
Yes 186 55 (29.6) 1.19 (0.86 - 1.65)  
Charlson Comorbidity Index 0 599 177 (29.6) 1.00  
1-2 65 13 (20.0) 0.70 (0.40 - 1.24)  
Missing 2 0 (0.0) -  
Hormonal factors      
Oral contraceptives use prior to diagnosis No 189 48 (25.4) 1.00  
Yes 477 142 (29.8) 1.12 (0.79 - 1.58)  
Estrogen use prior to diagnosisd,e No 120 26 (21.7) 1.00  
Yes 210 52 (24.8) 1.36 (0.83 - 2.24)  
Missing 11 2 (18.2) -  
Progestin use prior to diagnosisd,e No 205 52 (25.4) 1.00  
Yes 119 23 (19.3) 0.94 (0.56 - 1.59)  
Missing 17 5 (29.4) -  
Lifestyle factors      
Pack-years of smoking <100 cigarettes in lifetime, <0.05 pack-years 326 92 (28.2) 1.00  
0.05-5.3 pack-years 112 33 (29.5) 1.06 (0.71 - 1.58)  
5.4-20.5 pack-years 111 37 (33.3) 1.31 (0.89 - 1.93)  
>20.5 pack-years 114 27 (23.7) 0.93 (0.60 - 1.44)  
Missing 3 1 (33.3) -  
Per pack-year of smoking    1.00 (0.99 - 1.01)  
    P trend = 0.47  
Alcohol intake year prior to diagnosis (grams per day) <1 329 102 (31.0) 1.00  
1-6 99 25 (25.3) 0.82 (0.52 - 1.28)  
>6 117 29 (24.8) 0.94 (0.61 - 1.45)  
Missing 121 34 (28.1) 1.28 (0.79 - 2.09)  
Per gram of alcohol    0.99 (0.97 - 1.01)  
    P trend = 0.42  
Sports and recreational activities year prior to diagnosis (MET hours/week) <0.5 223 68 (30.5) 1.00  
0.5-20.0 298 85 (28.5) 1.13 (0.80 - 1.59)  
>20.0 144 37 (25.7) 1.09 (0.71 - 1.67)  
Missing 1 0 (0.0) -  
Per MET hour    1.00 (0.99 - 1.01)  
    P trend = 0.80  
  1. aHR is adjusted for race/ethnicity (non-Hispanic white (New Mexico), non-Hispanic white (Western Washington), black (Los Angeles), Hispanic (New Mexico)) and age at diagnosis (35-44, 45-49, 50-54, 55-59, 60-64). Age is adjusted for only race/ethnicity. Race/ethnicity is adjusted for only age. bCox proportional hazard model includes age, race/ethnicity, surgery type, number of excised lymph nodes, chemotherapy, BMI, and hypertension. c‘1 to 9’ category includes ‘at least one lymph node removed’. dAge in years (35 to 64) was used to adjust for the age effect. eOnly postmenopausal women were included. N, number; LE, lymphedema; HR, hazard ratio; CI, confidence interval; NOS, not otherwise specified; NM, New Mexico; WW, Western Washington; LA, Los Angeles County; BMI, body mass index; MET, metabolic equivalent task.