Taxane-Based and Long-Course Chemotherapy Linked to Higher Breast Cancer-Related Lymphedema Risk

This retrospective cohort from Guangzhou Red Cross Hospital included 201 patients with pathologically confirmed breast cancer who underwent surgical treatment between January 1, 2020, and December 23, 2023. The study evaluated associations between chemotherapy approaches—specifically taxane-based regimens, long-course chemotherapy, and the combination of neoadjuvant and adjuvant chemotherapy—and the incidence of breast cancer-related lymphedema (BCRL). Follow-up duration was not reported.

BCRL occurred in 31 patients (15.4%) out of 201 total patients. Compared with patients not receiving chemotherapy or receiving different regimens, taxane-based regimens were associated with an odds ratio of 4.018 (95% CI 1.162–13.890, P<0.05). Long-course chemotherapy was associated with an odds ratio of 4.887 (95% CI 1.396–17.116, P<0.05). The combination of neoadjuvant and adjuvant chemotherapy was associated with an odds ratio of 4.50 (95% CI 1.14–17.762, P<0.05). All reported associations were positive and statistically significant.

Safety and tolerability data were not reported. Key limitations include the retrospective, single-center design and reliance on univariate analysis without multivariate adjustment. The study reports an association only and cannot establish causation. Certainty is limited by study design and analytical approach. Generalizability beyond this population is uncertain.

Practice relevance is cautious: these findings may inform vigilant monitoring for BCRL in patients receiving taxane-based regimens, long-course chemotherapy, or combined neoadjuvant and adjuvant chemotherapy. Clinicians should interpret these results as hypothesis-generating and consider them alongside patient-specific risk factors and treatment goals.