Glucagon-like peptide−1 receptor agonist use and risk of postmastectomy lymphedema in breast cancer survivors: a multicenter real-world cohort study
- 1Department of Internal Medicine, Jefferson Einstein Philadelphia Hospital, Philadelphia, PA USA
- 2Department of Hematology and Oncology, Jefferson Einstein Philadelphia Hospital, Philadelphia, PA USA
- 3The University of Texas, San Antonio, San Antonio, TX USA
Abstract
Purpose: Postmastectomy lymphedema is a chronic survivorship complication after breast cancer treatment, particularly among patients exposed to axillary surgery. Obesity and metabolic inflammation are recognized contributors to lymphedema risk. This study evaluated whether glucagon-like peptide − 1 receptor agonist exposure was associated with lower incidence of coded postmastectomy lymphedema among breast cancer patients with mastectomy and/or axillary procedure exposure.
Methods: We performed a retrospective cohort study using deidentified electronic health record data from the TriNetX Research Network. Adult patients with breast cancer and coded mastectomy and/or axillary procedural exposure were stratified by GLP-1 receptor agonist exposure versus no exposure. One-to-one propensity score matching was used to balance measured baseline characteristics. The primary outcome was incident coded postmastectomy lymphedema syndrome. Outcomes were assessed from 1 to 650 days after the index event using risk estimates, Kaplan–Meier analysis, and Cox proportional hazards models.
Results: After propensity score matching, 61,630 patients were included, with 30,815 patients in each cohort. Coded postmastectomy lymphedema occurred in 258 of 29,259 GLP-1 receptor agonist users and 779 of 30,237 non-users, corresponding to incidence rates of 0.88% and 2.58%, respectively. GLP-1 receptor agonist exposure was associated with lower incidence of coded postmastectomy lymphedema in time-to-event analysis (hazard ratio 0.373, 95% CI 0.324–0.429; p < 0.001). The absolute risk difference was − 1.7%, with an estimated number needed to treat of 59.
Conclusion: In this large real-world breast cancer surgical/procedural cohort, GLP-1 receptor agonist exposure was associated with lower incidence of coded postmastectomy lymphedema over 650 days of follow-up. These findings are hypothesis-generating and require prospective validation with systematic lymphedema assessment and detailed characterization of GLP-1 receptor agonist timing, duration, dose, and adherence.
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BibTeX
@article{yesho2026glucagonlike,
title = {{Glucagon-like peptide−1 receptor agonist use and risk of postmastectomy lymphedema in breast cancer survivors: a multicenter real-world cohort study}},
author = {Dawit Hailemariam Yesho and Muluken Zeleke Megiso and Chidiebube Ugwu and Ariana N. Neely and Tarfa Verinumbe and Gabor Varadi and Colton Jones},
journal = {Supportive Care in Cancer},
year = {2026},
month = oct,
doi = {10.1007/s00520-026-11405-3},
url = {https://doi.org/10.1007/s00520-026-11405-3},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Glucagon-like peptide−1 receptor agonist use and risk of postmastectomy lymphedema in breast cancer survivors: a multicenter real-world cohort study
AU - Dawit Hailemariam Yesho
AU - Muluken Zeleke Megiso
AU - Chidiebube Ugwu
AU - Ariana N. Neely
AU - Tarfa Verinumbe
AU - Gabor Varadi
AU - Colton Jones
PY - 2026
DA - 2026/10/27
JO - Supportive Care in Cancer
DO - 10.1007/s00520-026-11405-3
UR - https://doi.org/10.1007/s00520-026-11405-3
AB - Purpose: Postmastectomy lymphedema is a chronic survivorship complication after breast cancer treatment, particularly among patients exposed to axillary surgery. Obesity and metabolic inflammation are recognized contributors to lymphedema risk. This study evaluated whether glucagon-like peptide − 1 receptor agonist exposure was associated with lower incidence of coded postmastectomy lymphedema among breast cancer patients with mastectomy and/or axillary procedure exposure. Methods: We performed a retrospective cohort study using deidentified electronic health record data from the TriNetX Research Network. Adult patients with breast cancer and coded mastectomy and/or axillary procedural exposure were stratified by GLP-1 receptor agonist exposure versus no exposure. One-to-one propensity score matching was used to balance measured baseline characteristics. The primary outcome was incident coded postmastectomy lymphedema syndrome. Outcomes were assessed from 1 to 650 days after the index event using risk estimates, Kaplan–Meier analysis, and Cox proportional hazards models. Results: After propensity score matching, 61,630 patients were included, with 30,815 patients in each cohort. Coded postmastectomy lymphedema occurred in 258 of 29,259 GLP-1 receptor agonist users and 779 of 30,237 non-users, corresponding to incidence rates of 0.88% and 2.58%, respectively. GLP-1 receptor agonist exposure was associated with lower incidence of coded postmastectomy lymphedema in time-to-event analysis (hazard ratio 0.373, 95% CI 0.324–0.429; p < 0.001). The absolute risk difference was − 1.7%, with an estimated number needed to treat of 59. Conclusion: In this large real-world breast cancer surgical/procedural cohort, GLP-1 receptor agonist exposure was associated with lower incidence of coded postmastectomy lymphedema over 650 days of follow-up. These findings are hypothesis-generating and require prospective validation with systematic lymphedema assessment and detailed characterization of GLP-1 receptor agonist timing, duration, dose, and adherence.
SN - 0941-4355
SN - 1433-7339
ER -