Factors associated with lymphedema after breast cancer surgery: a cross-sectional comparative study from Yazd, Iran

Lymphedema is a frequent complication following breast cancer surgery, and early identification of high‑risk patients is essential for prevention and timely management. This study aimed to identify clinical and treatment‑related factors associated with lymphedema among breast cancer patients. This analytical cross‑sectional comparative study included 155 women who underwent breast cancer surgery between 2018 and 2022 at Bagaipour Clinic in Yazd, Iran. Lymphedema was assessed at a single postoperative time point and defined as a ≥ 2 cm difference in arm circumference between the affected and contralateral arms. Comparisons between patients with and without lymphedema were performed using appropriate statistical tests, and multivariate logistic regression was used to identify independent associations. Lymphedema was diagnosed in 52 of 155 patients (33.5%). In adjusted analysis, higher body mass index (BMI), advanced tumor stage, and hyperlipidemia were independently associated with lymphedema. Each 1 kg/m² increase in BMI was associated with 10% higher odds of lymphedema (OR = 1.10; 95% CI: 1.02–1.21). Patients with higher tumor stage had significantly increased odds (OR = 3.7; 95% CI: 1.8–7.4). Hyperlipidemia was also associated with greater odds of lymphedema (OR = 3.5; 95% CI: 1.1–11.2). Hypertension, diabetes, and type of surgery were not independently associated with lymphedema after adjustment. Approximately one-third of breast cancer patients in this cohort experienced lymphedema. Higher BMI, advanced tumor stage, and hyperlipidemia were significantly associated with the condition. Given the cross-sectional study design, these findings reflect associations rather than causal relationships. Identifying patients with these characteristics may help guide risk-based surveillance and preventive strategies.