McWayne Janis, Heiney Sue P
School of Education, Francis Marion University, 4822 E. Palmetto Street, Florence, SC 29506, USA.
Cancer. 2005 Aug 1;104(3):457-66. doi: 10.1002/cncr.21195.
The psychological and social sequelae of secondary lymphedema (SLE) have been an underrecognized and little-researched complication of treatment for breast carcinoma. The reported incidence and prevalence of SLE varied widely (0-48%). Reported reasons for the differences are related to the lack of standard diagnostic and universal assessment criteria.
A comprehensive, computerized search was performed. All combinations of the following keywords were used: arm lymphedema, arm swelling, breast cancer, psychological and social, and quality of life (QOL). Eighteen studies were identified.
The literature supported the view that SLE leads to psychological and social sequelae. Psychological sequelae included frustration, distress, depression and anxiety. Social sequelae comprised changes in role function, lack of social support and pain and disability. Pain was a significant predictor of psychological and social morbidity. These experiences resulted in diminution of QOL, particularly psychological and social health. This was particularly worrisome because women must attend daily to the precautions and treatments for SLE.
Researchers should use psychological and social measures along with physiologic parameters when evaluating the impacts of SLE. Clinicians should work to develop standardized primary prevention programs and limb circumference should be measured at the time of breast carcinoma diagnosis. Gaps in knowledge related to intra/interethnic diversity, poverty, and comorbidities of women with breast carcinoma-related SLE need to be explored. The combined efforts of researchers and clinicians would reinforce awareness and knowledge for women at risk and provide important baseline data for research and practice.
继发性淋巴水肿（SLE）的心理和社会后遗症一直是乳腺癌治疗中未得到充分认识且研究较少的并发症。报道的SLE发病率和患病率差异很大（0 - 48%）。报道的差异原因与缺乏标准诊断和通用评估标准有关。
进行了全面的计算机检索。使用了以下关键词的所有组合：手臂淋巴水肿、手臂肿胀、乳腺癌、心理和社会以及生活质量（QOL）。共识别出18项研究。
文献支持SLE会导致心理和社会后遗症的观点。心理后遗症包括挫折感、痛苦、抑郁和焦虑。社会后遗症包括角色功能变化、缺乏社会支持以及疼痛和残疾。疼痛是心理和社会发病的重要预测因素。这些经历导致生活质量下降，尤其是心理和社会健康方面。这尤其令人担忧，因为女性必须每天注意SLE的预防措施和治疗。
研究人员在评估SLE的影响时应使用心理和社会测量方法以及生理参数。临床医生应努力制定标准化的一级预防方案，并且应在乳腺癌诊断时测量肢体周长。需要探索与种族内/种族间差异、贫困以及患有与乳腺癌相关的SLE的女性的合并症相关的知识空白。研究人员和临床医生的共同努力将增强对有风险女性的认识和了解，并为研究和实践提供重要的基线数据。
