Complicated breast cancer–related lymphedema: evaluating health care resource utilization and associated costs of management

Basta, Marten N.; Fox, Justin P.; Kanchwala, Suhail; Wu, Liza C.; Serletti, Joseph M.; Kovach, Stephen J.; Fosnot, Joshua; Fischer, John P.

doi:10.1016/j.amjsurg.2015.06.015

Cited by 61 publications

(61 citation statements)

References 40 publications

(34 reference statements)

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“…Shih et al found that the 2‐year mean costs for women with BCRL were a significant US$23 167 higher than for patients with breast cancer without lymphedema (BC). In a recent study of 56 075 women, 2.3% had at least 1 hospital admission for complicated lymphedema within 2 years of breast cancer surgery . Along with significantly more inpatient admissions, patients with BCRL incurred nearly 7‐fold greater health care charges compared with those patients without lymphedema.…”

Section: Introductionmentioning

confidence: 99%

“…In a recent study of 56 075 women, 2.3% had at least 1 hospital admission for complicated lymphedema within 2 years of breast cancer surgery. 16 Along with significantly more inpatient admissions, patients with BCRL incurred nearly 7-fold greater health care charges compared with those patients without lymphedema. This high rate of hospitalization resulted in substantially higher health care charges (US$58 088 vs US$31 819 per patient, P < .001) over the 2-year period after surgery.…”

Section: Introductionmentioning

confidence: 99%

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Financial cost of lymphedema borne by women with breast cancer

Boyages

Kalfa

et al. 2016

Psycho-Oncology

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ObjectiveOur study examines the financial cost of lymphedema following a diagnosis of breast cancer and addresses a significant knowledge gap regarding the additional impact of lymphedema on breast cancer survivors.MethodsAn online national survey was conducted with 361 women who had either breast cancer without lymphedema (BC) (group 1, n = 209) or breast cancer with lymphedema (BC+LE) (group 2, n = 152). Participant recruitment was supported by the Breast Cancer Network Australia and the Australasian Lymphology Association.ResultsBoth breast cancer and lymphedema result in significant out‐of‐pocket financial costs borne by women. Of patients with BC+LE, 80% indicated that their breast cancer diagnosis had affected them financially compared with 67% in the BC group (P < .020). For patients with lymphedema, over half (56%) indicated that this specific additional diagnosis to their breast cancer affected them financially and that costs increased with lymphedema severity. The cost of compression garments formed a large proportion of these costs (40.1%). The average number of attendances to a therapist each year was 5.8 (range, 0‐45). Twenty‐five patients (16.4%) had an episode of cellulitis in the past year. The incidence of cellulitis was 7.7% in 91 patients with subclinical or mild lymphedema compared with 29.5% of 61 patients with more extensive lymphedema (P < .001). The average out‐of‐pocket financial cost of lymphedema care borne by women was A$977 per annum, ranging from A$207 for subclinical lymphedema to over A$1400 for moderate or severe lymphedema.ConclusionsThis study identifies an additional detrimental effect of lymphedema on women in terms of financial costs.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Financial cost of lymphedema borne by women with breast cancer

Boyages

Kalfa

et al. 2016

Psycho-Oncology

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“…4 Postoperative wound infection likely confers added risk for lymphedema; however, a well-recognized complication of lymphedema is recurrent cellulitis. 5,6 Preoperative baseline comorbidities and surgical characteristics were prioritized here because we can only counsel patients about what we already know, and we would need to estimate individual risk for postoperative infection to adjust lymphedema risk accordingly. Moreover, a prospective study design is better suited to determine the precise temporal relationship between the two on a scale the size of this 5 W e read with interest the recent article by Dr. Roostaeian and colleagues regarding anatomic considerations to prevent facial nerve injury.…”

Section: Sirmentioning

confidence: 99%

“…5,6 Preoperative baseline comorbidities and surgical characteristics were prioritized here because we can only counsel patients about what we already know, and we would need to estimate individual risk for postoperative infection to adjust lymphedema risk accordingly. Moreover, a prospective study design is better suited to determine the precise temporal relationship between the two on a scale the size of this 5 W e read with interest the recent article by Dr. Roostaeian and colleagues regarding anatomic considerations to prevent facial nerve injury. 1 The authors provided a state-of-art analysis of the facial nerve branches to improve the understanding of facial softtissue anatomy when applied to face lift procedures, in order to outline safe planes of dissection for each branch during surgical undermining.…”

Section: Sirmentioning

confidence: 99%

Reply: A Propensity-Matched Analysis of the Influence of Breast Reconstruction on Subsequent Development of Lymphedema

Basta

Fischer

Kanchwala

et al. 2016

Plastic &Amp; Reconstructive Surgery

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“…11 Due to the reduced capacity of the remaining lymph nodes to remove excess interstitial fluid, lymphedema develops as a consequence and affects between 12-28% of women treated for breast cancer. 12 Lymphedema may also occur after radiotherapy due to the formation of scar tissue impeding lymph flow. Lymphedema presents as swelling of the affected arm that involves pain, heaviness and a disrupted functioning of everyday tasks.…”

Section: Introductionmentioning

confidence: 99%

Breast Cancer and Lymphedema: A Narrative Review

Michaelides

Constantinou

2019

Int J Med Students

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Breast cancer is the second most common cancer diagnosed worldwide, and the leading cause of cancer death in women. The understanding of disease presentation by patients and health care providers is crucial for a correct diagnosis and management. Preventive measures emphasize risk-reducing behaviors such as a healthy diet, reduced alcohol consumption, increased physical activity, and breastfeeding children. Screening techniques such as mammography, ultrasound, and MRI aid in early detection. Following the screening, a breast biopsy is performed, and a histopathological assessment is carried out to confirm a breast cancer diagnosis. In addition to surgery, radiotherapy, and lifestyle modifications, treatment regimens include a range of medications such as anti-hormonal drugs and chemotherapy. Lymphedema is a severe and major long-term consequence of breast cancer treatment. The major contributors to the diminished lymph drainage are a lumpectomy/mastectomy procedure that involves the surgical removal of lymph nodes, and radiotherapy. The fluid accumulation of lymphedema poses physical limitations to the patient and impacts the overall quality of life. A sentinel lymph node biopsy is an essential method of identifying the first draining lymph nodes affected by metastasis. This procedure allows surgeons to later remove only affected lymph nodes, sparing those that are unaffected and hence reduce the risk and magnitude of lymphedema development. Patients who receive education about lymphedema demonstrate higher compliance with treatment and self-care management practices. The purpose of this review is to provide information about breast cancer, the development of lymphedema, and how to recognize and manage both.

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Complicated breast cancer–related lymphedema: evaluating health care resource utilization and associated costs of management

Cited by 61 publications

References 40 publications

Financial cost of lymphedema borne by women with breast cancer

Financial cost of lymphedema borne by women with breast cancer

Reply: A Propensity-Matched Analysis of the Influence of Breast Reconstruction on Subsequent Development of Lymphedema

Breast Cancer and Lymphedema: A Narrative Review

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