Improving the quality of life in breast cancer survivors at risk for lymphedema

Surgery. 2019 Oct;166(4):686-690. doi: 10.1016/j.surg.2019.05.048. Epub 2019 Aug 29.

Abstract

Background: Certain treatments increase lymphedema risk in breast cancer survivors. The purpose of this study was to determine whether quality of life improved with preoperative teaching by a lymphedema expert.

Methods: Preoperative breast cancer patients were prospectively randomized into intervention group 1 or control group 2. Group 1 had a discussion with the lymphedema expert and at 6 months, in addition to the preoperative surgical discussion and literature given to all. Arm measurements and quality of life evaluation with Functional Assessment of Cancer Therapy-Breast Cancer were completed preoperatively and at intervals for up to 3 years. Lymphedema was verified with a 10% increase in volume or circumference. Univariate and multivariate analysis were performed on data.

Results: There were 119 evaluable patients with no differences between groups 1 and 2. The rate of acute lymphedema was 51.5% (33 of 64) for group 1 and 47.2% (26 of 55) for group 2. Chronic lymphedema presented in 13 patients (9.3% group 1 and 12.7% group 2). Lymphedema was significantly associated with number of lymph nodes resected (P < .001). Significant findings in the Functional Assessment of Cancer Therapy-Breast Cancer were at 6 months for all and after diagnosis in lymphedema positive patients.

Conclusion: Structured lymphedema teaching can help to improve quality of life in lymphedema patients.

Publication types

  • Randomized Controlled Trial
  • Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

  • Adult
  • Aged
  • Breast Neoplasms / pathology
  • Breast Neoplasms / surgery*
  • Cancer Survivors / psychology*
  • Chronic Disease
  • Female
  • Follow-Up Studies
  • Humans
  • Lymph Node Excision / adverse effects*
  • Lymph Node Excision / methods
  • Lymphedema / etiology
  • Lymphedema / physiopathology
  • Lymphedema / psychology
  • Lymphedema / therapy*
  • Mastectomy / adverse effects*
  • Mastectomy / methods
  • Middle Aged
  • Patient Education as Topic / methods*
  • Preoperative Care / methods
  • Prospective Studies
  • Treatment Outcome