Psychological consequences of lymphoedema associated with breast cancer: A prospective cohort study

Vassard, Ditte; Olsen, Maja Halgren; Zinckernagel, Line; Vibe-Petersen, Jette; Dalton, Susanne Oksbjerg; Johansen, Christoffer

doi:10.1016/j.ejca.2010.07.041

Cited by 86 publications

(57 citation statements)

References 25 publications

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“…Studies were categorized by level of evidence as follows: 8 studies were level I [4, 11–17], 14 studies level II [18–31], 8 level III [2, 32–38], and 9 studies level IV [39–47]. Sixteen [4, 11–13, 15, 16, 18, 20–22, 26, 27, 31, 34, 38, 46] of 39 studies were compliant with the Efficace criteria (Table 1).…”

Section: Resultsmentioning

confidence: 99%

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Quality of life among breast cancer patients with lymphedema: a systematic review of patient-reported outcome instruments and outcomes

et al. 2012

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Purpose Lymphedema following breast cancer surgery remains a common and feared treatment complication. Accurate information on health-related quality of life (HRQOL) outcomes among patients with lymphedema is critically needed to inform shared medical decision making and evidence-based practice in oncologic breast surgery. Our systematic review aimed to (1) identify studies describing HRQOL outcomes in breast cancer-related lymphedema (BCRL) patients, (2) assess the quality of these studies, and (3) assess the quality and appropriateness of the patient-reported outcome (PRO) instruments used. Methods Using the PRISMA statement, we performed a systematic review including studies describing HRQOL outcomes among BCRL patients. Studies were classified by levels of evidence and fulfillment of the Efficace criteria. PRO instruments were assessed using the COSMIN criteria. Results Thirty-nine studies met inclusion criteria, including 8 level I and 14 level II studies. Sixteen of 39 studies were compliant with the Efficace criteria. Seventeen HRQOL instruments were used, two specific to lymphedema patients. Exercise and complex decongestive therapy treatment interventions were associated with improved HRQOL. Conclusions High-quality data on HRQOL outcomes is required to inform surgical decisions for breast cancer management and survivors. Of the lymphedema-specific PRO instruments, the Upper Limb Lymphedema 27 (ULL-27) was found to have strong psychometric properties. Future studies should strive to use high-quality condition-specific PRO instruments, follow existing guidelines for HRQOL measurement and to consider economic burdens of BCRL. Implications for Cancer Survivors As lymphedema may develop many years after breast cancer surgery, the ULL-27 may offer greater content validity for use in survivorship research.

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Section: Resultsmentioning

confidence: 99%

“…Sixteen [4, 11–13, 15, 16, 18, 20–22, 26, 27, 31, 34, 38, 46] of 39 studies were compliant with the Efficace criteria (Table 1). Of the 16 compliant studies, six were level I studies, seven level II, two level III, and one level IV.…”

Section: Resultsmentioning

confidence: 99%

Quality of life among breast cancer patients with lymphedema: a systematic review of patient-reported outcome instruments and outcomes

et al. 2012

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“…Prevention and treatment of infection are paramount. Women with lymphedema can also experience functional impairment as well as decreased emotional well-being [51]. If the lymphedema is refractory to treatment or has a late onset (years after diagnosis and treatment) without apparent cause, tumor recurrence or the development of lymphangiosarcoma should be considered.…”

Section: Lymphedemamentioning

confidence: 99%

Symptom Management in Metastatic Breast Cancer

2011

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Approximately 40,000 women die as a result of breast cancer each year and many more live with advanced disease. When breast cancer recurs, the goals of treatment often shift from one of cure to controlling the disease for as long as possible while palliating symptoms interfering with the patient's functional status and quality of life. This requires ongoing discussions with the patient and family about the goals of care. Many symptoms depend on the site of metastasis, with bone being the most frequent, and commonly occur with fatigue, depression, insomnia, and pain. The purpose of this paper is to identify and provide an overview of the management of the most common symptoms in patients with breast cancer metastases.

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Section: Introductionmentioning

confidence: 99%

“…For instance, the consequences for intimate relationships and social functioning are considerable-increased social inhibition and withdrawal, and sexual functioning impairment [19,[26][27][28]. The visible nature of AM, particularly lymphedema, can engender body image disturbance and fears of being stigmatized [27][28][29]. Moreover, the functional limitations associated with restrictions in arm or shoulder ROM can impact a survivor's ability to perform activities of daily living and work [30,31], decreasing independence, and creating financial burden [32].…”

Section: Introductionmentioning

confidence: 99%

A longitudinal analysis of chronic arm morbidity following breast cancer surgery

Boquiren

Hack

Thomas

et al. 2016

Breast Cancer Res Treat

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Arm morbidity (AM) arising from breast cancer (BC) treatment can detrimentally impact quality of life; often limiting a survivor's ability to participate in valued activities. The present study explored (a) the developmental time course of AM [restricted range of motion (ROM), pain, and arm volume changes], negative affect, and perceived disability in the immediate years post-surgery, and (b) the mediating role of perceived disability on the relationship between AM and negative affect over time. In this 5-year longitudinal study, BC survivors from four Canadian oncology clinics (n = 431) completed five annual clinical assessments, where differences in ROM (shoulder abduction, external rotation) and arm volume between the affected and non-affected arm were measured. The profile of mood states (POMS), disability of arm, shoulder, hand, and McGill Pain Questionnaire-Short form were completed. Results from general linear modeling showed that AM, negative affect, and perceived disability were greatest 1-year post-surgery, declined, and with the exception of arm volume changes, were significantly lower 5 years later. Negative affect was significantly associated with restrictions in shoulder abduction and external rotation (average r = -0.15; p < 0.05) and present arm pain (average r = 0.28, p < 0.01) at most assessments. The mediating role of perceived disability on the relationship between AM and negative affect was statistically significant in a majority of assessments. Perceived disability is the underlying factor driving the relationship between AM and mood disturbance over time. Rehabilitative therapy to improve survivors' functional well-being might mitigate the negative impacts of AM on emotional health.

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Psychological consequences of lymphoedema associated with breast cancer: A prospective cohort study

Cited by 86 publications

References 25 publications

Quality of life among breast cancer patients with lymphedema: a systematic review of patient-reported outcome instruments and outcomes

Quality of life among breast cancer patients with lymphedema: a systematic review of patient-reported outcome instruments and outcomes

Symptom Management in Metastatic Breast Cancer

A longitudinal analysis of chronic arm morbidity following breast cancer surgery

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