Effects of dietary habits and catheterization type on breast cancer-related lymphedema: a retrospective cohort study

Abstract Background Understanding the factors that contribute to variability in breast cancer-related lymphedema (BCRL) is an important first step in developing targeted interventions to improve quality of life in breast cancer patients. Although previous research studies have has identified many risk factors for BCRL, dietary habits and catheterization type have rarely been studied until the present.This study aims to explore the effects of dietary habits and catheterization type on BCRL. Methods This study included 1,476 breast cancer patients after surgery between January 1, 2010 and September 1, 2020. Lymphedema was assessed with a validated self-reported questionnaire. All research data was obtained by medical records and follow-up database. Survival analysis was conducted to explore the effects of dietary habits and catheterization type on BCRL. Results The result showed an increased risk for BCRL among breast cancer patients who followed a high-fat diet pre-hospitalization (hazard ratio [HR] =2.473; P<0.001), indwelling totally implantable venous access ports (TIVAPs) compared with indwelling needle (HR=0.558; P=0.017) and indwelling TIVAPs, compared with anindwelling peripherally inserted central catheter (PICC) (HR=0.691; P=0.086). Conclusion High-fat diet pre-hospitalization was an independent risk factor for lymphedema. The TIVAPs did not exert a protective effect on lymphedema compared with the PICC and indwelling needle. This study finding offers new insights to develop targeted interventions to decrease the incidence of lymphedema.