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Journal of Obesity
Volume 2016, Article ID 8241710, 9 pages
http://dx.doi.org/10.1155/2016/8241710
Research Article

Race or Resource? BMI, Race, and Other Social Factors as Risk Factors for Interlimb Differences among Overweight Breast Cancer Survivors with Lymphedema

1Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA
2MedStar Health Research Institute and MedStar Georgetown University Hospital, Division of Biostatistics, Washington, DC 20007, USA
3School of Arts & Sciences, University of Pennsylvania, Philadelphia, PA 19104, USA
4The Wharton School of the University of Pennsylvania, Philadelphia, PA 19104, USA
5Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA
6Recruitment, Outcomes, and Assessment Resource Core, University of Pennsylvania, Philadelphia, PA 19104, USA
7The Mayo Clinic, Department of Physical Medicine and Rehabilitation, Rochester, MN 55905, USA

Received 8 January 2016; Revised 16 May 2016; Accepted 6 June 2016

Academic Editor: Eric Doucet

Copyright © 2016 Lorraine T. Dean et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Introduction. High BMI is a risk factor for upper body breast cancer-related lymphedema (BCRL) onset. Black cancer survivors are more likely to have high BMI than White cancer survivors. While observational analyses suggest up to 2.2 times increased risk of BCRL onset for Black breast cancer survivors, no studies have explored race or other social factors that may affect BCRL severity, operationalized by interlimb volume difference (ILD). Materials and Methods. ILD was measured by perometry for 296 overweight (25 > BMI < 50) Black () or White () breast cancer survivors (>6 months from treatment) in the WISER Survivor trial. Multivariable linear regression examined associations between social and physical factors and ILD. Results. Neither Black race (−0.26, ) nor BMI (0.22, ) was associated with ILD. Attending college (−4.89, ) was the strongest factor associated with ILD, followed by having more lymph nodes removed (4.75, ), >25% BCRL care adherence (4.10, ), and years since treatment (0.55, ). Discussion. Neither race nor BMI was associated with ILD among overweight cancer survivors. Education, a proxy for resource level, was the strongest factor associated with greater ILD. Tailoring physical activity and weight loss interventions designed to address BCRL severity by resource rather than race should be considered.