Breast cancer-related lymphedema and its treatment: how big is the financial impact?

Vrieze, Tessa De; Gebruers, Nick; Nevelsteen, Ines; Tjalma, Wiebren A.A.; Thomis, Sarah; Groef, An De; Dams, Lore; Haenen, Vincent; Devoogdt, Nele

doi:10.1007/s00520-020-05890-3

Cited by 9 publications

(12 citation statements)

References 32 publications

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“…The economic burden of BCRL is high for patients and the health care system (28,(63)(64)(65). Three weeks of lymphatic decongestive treatment by a physiotherapist and follow-up require on average USD 2,648 per patient.…”

Section: Discussionmentioning

confidence: 99%

“…Three weeks of lymphatic decongestive treatment by a physiotherapist and follow-up require on average USD 2,648 per patient. Additionally, the required compression stockings cost on average USD 937 per patient ( 28 ). Finally, there are other non-medical costs such as transportation and loss of productivity due to morbidity and mortality.…”

Section: Discussionmentioning

confidence: 99%

“…The treatment for BCRL focuses on volume control through physiotherapy and compression garments (25)(26)(27), which represents a high economic burden for patients and the health care system (28). Identifying strategies to prevent BCRL in individuals at high risk, and to improve quality of life of patients is necessary (27).…”

Section: Introductionmentioning

confidence: 99%

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Effect of Supervised Resistance Training on Arm Volume, Quality of Life and Physical Perfomance Among Women at High Risk for Breast Cancer-Related Lymphedema: A Study Protocol for a Randomized Controlled Trial (STRONG-B)

et al. 2022

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ObjectivesTo determine the preventive effects of supervised resistance training on arms volume, quality of life, physical performance, and handgrip strength in Chilean women at high risk for breast cancer-related lymphedema (BCRL) undergoing chemotherapy.DesignRandomized control trial.ParticipantsOne hundred and six women at high risk for breast cancer-related lymphedema aged 18 to 70 years.InterventionsParticipants will be randomized into two groups: [a] intervention, who will receive 12 weeks of supervised resistance training (STRONG-B) during adjuvant chemotherapy; and [b] control, who will receive education to promote lymphatic and venous return, maintain range of motion, and promote physical activity.Main Outcome MeasuresThe primary outcome will be arms volume measured with an optoelectric device (perometer NT1000). Secondary outcomes will be quality of life, handgrip strength, and physical performance. Primary and secondary outcomes will be measured at baseline, just after the intervention, and 3 and 6 months after. Statistical analysis will be performed following intention-to-treat and per-protocol approaches. The treatment effect will be calculated using linear mixed models.DiscussionThe STRONG-B will be a tailored supervised resistance training that attempts to prevent or mitigate BCRL in a population that, due to both intrinsic and extrinsic factors, will commonly suffer from BCRL.Clinical Trial Registration[https://clinicaltrials.gov/ct2/show/NCT04821609], identifier NCT04821609.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Effect of Supervised Resistance Training on Arm Volume, Quality of Life and Physical Perfomance Among Women at High Risk for Breast Cancer-Related Lymphedema: A Study Protocol for a Randomized Controlled Trial (STRONG-B)

et al. 2022

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“…Nevertheless, regrettably, given the large increase in BC survivors prevalence, the cost-effectiveness and sustainability of lymphedema treatment have been largely discussed [ 41 ]. Therefore, in recent years, there is growing attention on effective strategies of self-management education for lymphedema.…”

Section: Management Strategies For Lymphedemamentioning

confidence: 99%

Surgical Treatment and Rehabilitation Strategies for Upper and Lower Extremity Lymphedema: A Comprehensive Review

et al. 2022

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Lymphedema is a chronic disabling condition affecting a growing number of patients worldwide. Although lymphedema is not life-threatening, several reports underlined detrimental consequences in terms of distress, pain, functional impairment, and infections with a relevant decrease in quality of life. Currently, there is no cure, and the therapeutic management of this condition aims at slowing down the disease progression and preventing secondary complications. Early diagnosis is paramount to enhance the effects of rehabilitation or surgical treatments. On the other hand, a multidisciplinary treatment should be truly integrated, the combination of microsurgical and reductive procedures should be considered a valid strategy to manage extremity lymphedema, and rehabilitation should be considered the cornerstone of the multidisciplinary treatment not only for patients not suitable for surgical interventions but also before and after surgical procedures. Therefore, a specialized management of Plastic Reconstructive Surgeons and Physical and Rehabilitative Medicine physicians should be mandatory to address patients’ needs and optimize the treatment of this disabling and detrimental condition. Therefore, the aim of this review was to characterize the comprehensive management of lymphedema, providing a broad overview of the potential therapy available in the current literature to optimize the comprehensive management of lymphedema and minimize complications.

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“…Lymphedema is a chronic condition and is often not curable; therefore, long-term socioeconomic burden is expected. There have been many studies around the world on the economic burden associated with treatment of lymphedema after surgery in other cancers like breast cancer [13][14][15]. However, there is a lack of research on the cost of treating lymphedema in endometrial cancer.…”

Section: Introductionmentioning

confidence: 99%

Lymphedema in Endometrial Cancer Survivor: A Nationwide Cohort Study

Lee

Myong

Lee

et al. 2021

JCM

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Background: Endometrial cancer is the most common gynecological cancer in developed countries. Treatment-related lymphedema negatively affects the quality of life and function of patients. This study investigated the cumulative incidence and risk factors of, and utilization of health care resources for, lymphedema in patients with endometrial cancer. Methods: We conducted a nationwide, retrospective cohort study of women with endometrial cancer who underwent cancer-direct treatment using the Korean National Health Insurance Service (NHIS) database. Patients were categorized by age, region, income, and treatment modality. Cox proportional hazards regression models were used to analyze the incidence and risk factors of lymphedema. We also analyzed utilization of health care resources for lymphedema using diagnostic and treatment claim codes. Results: A total of 19,027 patients with endometrial cancer were evaluated between January 2004 and December 2017. Among them, 2493 (13.1%) developed lymphedema. Age (<40 years, adjusted odds ratio [aOR] = 1 vs. 40–59 years, aOR = 1.413; 95% confidence interval (CI) 1.203–1.66 vs. 60+ years, aOR = 1.472; 95% CI 1.239–1.748) and multimodal treatment (surgery only, aOR = 1 vs. surgery + radiation + chemotherapy, aOR = 2.571; 95% CI 2.27–2.912) are considered to be possible risk factors for lymphedema in patients with endometrial cancer (p < 0.001). The utilization of health care resources for the treatment of lymphedema has increased over the years. Conclusions: Lymphedema is a common complication affecting women with endometrial cancer and leads to an increase in national healthcare costs. Post-treatment surveillance of lymphedema, especially in high-risk groups, is needed.

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Breast cancer-related lymphedema and its treatment: how big is the financial impact?

Cited by 9 publications

References 32 publications

Effect of Supervised Resistance Training on Arm Volume, Quality of Life and Physical Perfomance Among Women at High Risk for Breast Cancer-Related Lymphedema: A Study Protocol for a Randomized Controlled Trial (STRONG-B)

Effect of Supervised Resistance Training on Arm Volume, Quality of Life and Physical Perfomance Among Women at High Risk for Breast Cancer-Related Lymphedema: A Study Protocol for a Randomized Controlled Trial (STRONG-B)

Surgical Treatment and Rehabilitation Strategies for Upper and Lower Extremity Lymphedema: A Comprehensive Review

Lymphedema in Endometrial Cancer Survivor: A Nationwide Cohort Study

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