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Improving the quality of life in breast cancer survivors at risk for lymphedema
Bland KL, Kosir MA
Surgery 2019 Oct;166(4):686-690
clinical trial
4/10 [Eligibility criteria: No; Random allocation: Yes; Concealed allocation: No; Baseline comparability: Yes; Blind subjects: No; Blind therapists: No; Blind assessors: No; Adequate follow-up: No; Intention-to-treat analysis: No; Between-group comparisons: Yes; Point estimates and variability: Yes. Note: Eligibility criteria item does not contribute to total score] *This score has been confirmed*

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 < 0.001). 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.

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