Ann Surg Oncol. 2010 Feb 6.
Fu MR, Chen CM, Haber J, Guth AA, Axelrod D.
College of Nursing, New York University, New York, NY, USA,
mf...@nyu.edu.
BACKGROUND: Despite recent advances in breast cancer treatment, breast
cancer related lymphedema (BCRL) continues to be a significant problem
for many survivors. Some BCRL risk factors may be largely unavoidable,
such as mastectomy, axillary lymph node dissection (ALND), or
radiation therapy. Potentially avoidable risk factors unrelated to
breast cancer treatment include minor upper extremity infections,
injury or trauma to the arm, overuse of the limb, and air travel. This
study investigates how providing information about BCRL affects the
cognitive and symptomatic outcome of breast cancer survivors.
METHODS: Data were collected from 136 breast cancer survivors using a
Demographic and Medical Information interview instrument, a Lymphedema
Education Status interview instrument, a Knowledge Test for cognitive
outcome, and the Lymphedema and Breast Cancer Questionnaire for
symptom outcome. Data analysis included descriptive statistics, t
tests, chi-square (chi(2)) tests, and regression.
RESULTS: BCRL information was given to 57% of subjects during
treatment. The mean number of lymphedema-related symptoms was 3
symptoms. Patients who received information reported significantly
fewer symptoms and scored significantly higher in the knowledge test.
After controlling for confounding factors, patient education remains
an additional predictor of BCRL outcome. Significantly fewer women who
received information about BCRL reported swelling, heaviness, impaired
shoulder mobility, seroma formation, and breast swelling.
CONCLUSIONS: Breast cancer survivors who received information about
BCRL had significantly reduced symptoms and increased knowledge about
BCRL. In clinical practice, breast cancer survivors should be engaged
in supportive dialogues so they can be educated about ways to reduce
their risk of developing BCRL.