Assessment of a risk warning model for depression in lymphedema patients after breast cancer surgery

To identify independent risk factors for depression in breast cancer patients with postoperative lymphedema and develop an early warning model for depression prevention.

120 breast cancer patients with postoperative lymphedema were divided into depression (n = 52) and non-depression (n = 68) groups based on the Self-Rating Depression Scale (SDS) administered 3 months after lymphedema onset. Data on demographics, clinical parameters, and social and cognitive functions were collected. Logistic regression analysis was used to identify independent risk factors. An early warning model was constructed and validated using temporal consecutive split-sample validation, with the first 120 consecutively enrolled patients constituting the development cohort and the subsequent 60 consecutive patients constituting the internal validation cohort.

Depression incidence was 43.33%. Univariate analysis showed significant differences in living arrangements, family income, surgical side, lymphedema severity, body image, pain level, sleep disturbances, lymphedema knowledge, and social support. Multivariate analysis identified low family income (<3000 yuan), poor body image, and low social support as independent risk factors. External validation in the temporal consecutive internal validation cohort (n = 60) confirmed these findings (AUC: 0.629, 95% CI: 0.487-0.772, sensitivity: 82.61%, specificity: 43.24%).

Breast cancer patients with postoperative lymphedema demonstrate high rates of depression, particularly among those with low family income, poor body image, and low social support. These factors represent potential targets for screening and intervention; however, causal relationships require confirmation through longitudinal and interventional studies.