Breast cancer survivors and lymphoedema: the relevance of education

Introduction

Secondary arm lymphoedema is a chronic and distressing condition, relatively common after axillary lymph node dissection (AND) for breast cancer. It may be associated with functional, esthetic, and psychological problems that actually could affect the quality-of-life (QOL) of breast cancer survivors. The present study describes the prevalence and characteristics of arm and hand swelling in patients undergoing breast cancer surgery in our institution.

Methods

We studied patients who underwent AND for breast cancer who had been diagnosed 4 years ago. We analyzed the prevalence of lymphoedema in these patients and reported data about pathologic and surgical characteristics.

Results

Seventy-five women, median age 61 years, were included. Nine women (12%) reported arm or hand swelling since their surgery, eight of them with mild swelling. Twenty-one (28%) reported current swelling and one-half of them constant swelling, mainly in the hand. Swelling was considered mild when it affected just the hand. Women who reported severe swelling had significantly worse physical functioning and depressive symptoms as well. Since the swelling has reduced the possibility of dressing appropriately and modified perceptions about general appearance, 92% of these women began treatment for swelling with a high grade of compliance (86%). We detected that just five women had high body mass index; all of them had more than 10 axillary lymph nodes evaluated and one-half of them were affected by the tumor.

Conclusion

Arm lymphoedema is a chronic problem for a subgroup of long-term survivors of breast cancer that negatively affects physical functioning. Educational efforts are needed for being aware of this problem so that survivors could identify this complication early and begin treatment to improve their physical functioning.