To investigate the clinical applicability and feasibility of the Bevilacqua risk prediction model for postoperative lymphedema in patients after breast conserving surgery for breast cancer.

From January 2010 to December 2015, clinical data of 203 breast cancer patients were analyzed retrospectively. Statistical analysis were performed by using SPSS24.0 software. Cox regression model was used to analyze the risk factors of postoperative lymphedema of patients’ upper extremity after breast conserving surgery. A P value of < 0.05 was considered as statistically significant difference. ROC curve was used to evaluate the prediction effect of the Bevilacqua model, Hosmer lemeshow test was used to verify the calibration ability of the Bevilacqua model. The calibration ability of the predictive model was considered as no difference between forecast and reality with a P value of >0.05.

The follow-up ranged from 62 to 86 months (median=70 months) . 45 patients (22.2%) had lymphedema of upper extremity within 5 years after operation. Cox regression model analysis showed that high BMI, neoadjuvant chemotherapy, total axillary lymph node dissection, and radiotherapy were independent risk factors for lymphedema of upper extremity. The ROC curve analysis of Bevilacqua model showed that the AUC value of the model was 0.711, 95% CI (0.651-0.760), which had a good prediction effect. Hosmer lemeshow test showed that there was no significant difference (P=0.262) between the predicted risk and the actual risk, with a good calibration ability.

The accuracy and applicability of the Bevilacqua model for predicting the risk of lymphedema in 6 months after operation are good, which could be used to predict the occurrence of lymphedema in breast cancer patients and could help to make intervention decisions for the prevention of lymphedema.