Model-Based Patterns of Lymphedema Symptomatology: Phenotypic and Biomarker Characterization

Curr Breast Cancer Rep. 2021 Mar;13(1):1-18. doi: 10.1007/s12609-020-00397-6. Epub 2020 Nov 24.

Abstract

Purpose of the study: More than 50% of breast cancer survivors without a diagnosis of lymphedema suffer daily from numerous and co-occurring lymphedema symptoms. This study aimed to identify lymphedema symptom patterns and the association of such patterns with phenotypic characteristics and biomarkers using latent class analysis (LCA). A prospective, descriptive, and repeated-measure design was used to enroll 140 women and collect data.

Recent findings: LCA identified three distinct lymphedema symptom classes at 8 weeks and 12 months post-surgery: low, moderate, and severe symptom classes and associated phenotypic characteristics. Participants were more likely to be in the severe symptom classes at 12 months post-surgery if they had lower education level, cording, an axillary syndrome at 8 weeks post-surgery, neoadjuvant chemotherapy, and radiation.

Summary: Pre-surgery level of IL1-a, IL-6, IL-8, and VEGF was associated with the severe symptom class at 8 weeks post-surgery, suggesting that such biomarkers may be used to predict risk for lymphedema symptoms.

Keywords: Bioimpedance; Biomarkers; Latent class analysis; Limbvolume; Lymphedema; Phenotype; Symptom; Symptom distress.