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Analysis of the Understanding and Worry about Lymphedema of Patients with Breast Cancer

  • Breast Oncology
  • Published:
Annals of Surgical Oncology Aims and scope Submit manuscript

Abstract

Background

Lymphedema is a potential lifelong sequela of breast cancer treatment. We sought to: (1) evaluate the worry and knowledge of patients about lymphedema, (2) quantify patients reporting lymphedema education and screening, and (3) determine willingness to participate in lymphedema screening and prevention programs.

Patients and Methods

A survey evaluating lymphedema-related knowledge and worry was sent to patients treated for stage 0–III breast cancer. Exclusion criteria included > 10 years since diagnosis, missing clinical staging, and those without axillary surgery. Responses were linked with clinicopathologic information.

Results

Of 141 patients meeting inclusion criteria, 89% of those without lymphedema were not at all or slightly worried about lymphedema. Higher levels of worry were associated with clinical stage II–III disease [odds ratio (OR) 2.63, p = 0.03], a history of axillary lymph node dissection (ALND) (OR 4.58, p < 0.01), and employment (OR 2.21, p = 0.05). A total of 102 (72%) patients recalled receiving lymphedema education. Lymphedema knowledge was limited, with < 25% of respondents answering > 50% of the risk factor questions correctly. Worry and knowledge were not significantly associated. Of patients without lymphedema, 36% were interested in learning more about lymphedema and 64% were willing to participate in or learn more about a screening program. Most (66%) felt that lymphedema information should be provided before and after cancer treatment.

Discussion

A majority of our breast cancer survivors had limited knowledge about lymphedema risk factors. While most patients were not worried about develo** lymphedema, higher worry was seen in patients with a higher clinical stage at diagnosis, ALND, and employment. Our findings suggest potential targets and timing for patient-centered educational interventions.

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Authors and Affiliations

  1. Department of Surgery, University of Iowa Hospitals and Clinics, Iowa City, IA, USA

    Rebecca A. Uhlmann MD, MS, Sonia L. Sugg MD, Lillian M. Erdahl MD, Ronald J. Weigel MD, PhD & Ingrid M. Lizarraga MBBS

  2. Holden Comprehensive Cancer Center, University of Iowa Hospitals and Clinics, Iowa City, IA, USA

    Sarah L. Mott MS & Melissa Curry MPH

  3. Department of Internal Medicine, University of Iowa Hospitals and Clinics, Iowa City, IA, USA

    Sneha Phadke DO, MPH

  4. Department of Surgery, University of Iowa Roy J. and Lucille A. Carver College of Medicine, Iowa City, IA, USA

    Ingrid M. Lizarraga MBBS

Authors
  1. Rebecca A. Uhlmann MD, MS
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  2. Sarah L. Mott MS
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  3. Melissa Curry MPH
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  4. Sneha Phadke DO, MPH
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  5. Sonia L. Sugg MD
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  6. Lillian M. Erdahl MD
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  7. Ronald J. Weigel MD, PhD
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  8. Ingrid M. Lizarraga MBBS
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Corresponding author

Correspondence to Ingrid M. Lizarraga MBBS.

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Disclosure

Research reported in this publication was supported by the National Cancer Institute of the National Institutes of Health under award number P30CA086862. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. Research reported in this publication was supported by the Patients Enhancing Research Collaboration at Holden Program (IRB 201708847) facilitated by the Biospecimen Procurement and Molecular Epidemiology Resource Core (BioMER) at the Holden Comprehensive Cancer Center.

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Uhlmann, R.A., Mott, S.L., Curry, M. et al. Analysis of the Understanding and Worry about Lymphedema of Patients with Breast Cancer. Ann Surg Oncol 29, 6428–6437 (2022). https://doi.org/10.1245/s10434-022-12189-6

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  • DOI: https://doi.org/10.1245/s10434-022-12189-6

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