Cellulitis is associated with severe breast cancer-related lymphedema: An observational study of tissue composition

Mads Gustaf Jørgensen*, Anne Pernille Hermann, Anette Riis Madsen, Steffanie Christensen, Kim Gordon Ingwersen, Jørn Bo Thomsen, Jens Ahm Sørensen

*Corresponding author for this work

Research output: Contribution to journalJournal articleResearchpeer-review

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Cellulitis is a common complication in Breast Cancer-Related Lymphedema (BCRL). The excess amount of fat and lean mass in BCRL is a vital factor in patient stratification, prognosis, and treatments. However, it is not known whether cellulitis is associated with the excess fat and lean mass in BCRL. Therefore, this prospective observational study was designed to fundamentally understand the heterogonous biocomposition of BCRL. For this study, we consecutively enrolled 206 patients with unilateral BCRL between January 2019 and February 2020. All patients underwent Dual-Energy X-Ray Absorptiometry scans, bioimpedance spectroscopy, indocyanine green lymphangiography comprehensive history of potential risk factors, and a clinical exam. Multivariate linear and beta regression models were used to determine the strength of association and margins effect. Sixty-nine patients (33%) had at least one previous episode of cellulitis. Notably, a previous episode of cellulitis was associated with 20 percentage points more excess fat and 10 percentage points more excess lean mass compared to patients without cellulitis (p < 0.05). Moreover, each 1 increase in the patients BMI was associated with a 0.03 unit increase in the fat mass proportion of the lymphedema arm. Cellulitis was associated with more excess fat and lean arm mass in BCRL. In addition, patients BMI affect the proportion of fat mass in the arm.

Original languageEnglish
Article number3584
Issue number14
Publication statusPublished - 2. Jul 2021


  • Bio composition
  • Bioimpedance
  • DEXA
  • Excess
  • Fat
  • Fluid
  • Lymphangiography
  • Lymphedema
  • Proportion


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