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

• Published in: Surgery Vol. 166; no. 4; pp. 686 - 690
• Main Authors: Bland, Keiva L., Kosir, Mary A.
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.10.2019
• Subjects: 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
• ISSN: 0039-6060; 1532-7361
• DOI: 10.1016/j.surg.2019.05.048

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