College of Nursing, New York University, New York, NY, USA.
Ann Surg Oncol. 2010 Jul;17(7):1847-53. doi: 10.1245/s10434-010-0941-3. Epub 2010 Feb 6.
Despite recent advances in breast cancer treatment, breast cancer related lymphedema (BCRL) continues to be a significant problem for many survivors. Some BCRL risk factors may be largely unavoidable, such as mastectomy, axillary lymph node dissection (ALND), or radiation therapy. Potentially avoidable risk factors unrelated to breast cancer treatment include minor upper extremity infections, injury or trauma to the arm, overuse of the limb, and air travel. This study investigates how providing information about BCRL affects the cognitive and symptomatic outcome of breast cancer survivors.
Data were collected from 136 breast cancer survivors using a Demographic and Medical Information interview instrument, a Lymphedema Education Status interview instrument, a Knowledge Test for cognitive outcome, and the Lymphedema and Breast Cancer Questionnaire for symptom outcome. Data analysis included descriptive statistics, t tests, chi-square (chi(2)) tests, and regression.
BCRL information was given to 57% of subjects during treatment. The mean number of lymphedema-related symptoms was 3 symptoms. Patients who received information reported significantly fewer symptoms and scored significantly higher in the knowledge test. After controlling for confounding factors, patient education remains an additional predictor of BCRL outcome. Significantly fewer women who received information about BCRL reported swelling, heaviness, impaired shoulder mobility, seroma formation, and breast swelling.
Breast cancer survivors who received information about BCRL had significantly reduced symptoms and increased knowledge about BCRL. In clinical practice, breast cancer survivors should be engaged in supportive dialogues so they can be educated about ways to reduce their risk of developing BCRL.
尽管乳腺癌治疗近年来取得了进展,但乳腺癌相关淋巴水肿(BCRL)仍然是许多幸存者面临的重大问题。一些 BCRL 风险因素在很大程度上可能是无法避免的,例如乳房切除术、腋窝淋巴结清扫术(ALND)或放射治疗。与乳腺癌治疗无关的潜在可避免的风险因素包括上肢轻微感染、手臂受伤或创伤、肢体过度使用和航空旅行。本研究调查了提供 BCRL 信息如何影响乳腺癌幸存者的认知和症状结果。
使用人口统计学和医疗信息访谈工具、淋巴水肿教育状况访谈工具、认知结果知识测试和淋巴水肿和乳腺癌问卷对 136 名乳腺癌幸存者进行了数据收集。数据分析包括描述性统计、t 检验、卡方检验(chi(2))和回归。
57%的受试者在治疗期间接受了 BCRL 信息。淋巴水肿相关症状的平均数量为 3 个症状。接受信息的患者报告的症状明显较少,知识测试得分明显更高。在控制混杂因素后,患者教育仍然是 BCRL 结果的另一个预测因素。接受 BCRL 信息的女性报告肿胀、沉重、肩部活动受限、血清肿形成和乳房肿胀的明显减少。
接受 BCRL 信息的乳腺癌幸存者症状明显减轻,对 BCRL 的了解也有所增加。在临床实践中,应与乳腺癌幸存者进行支持性对话,以便对他们进行有关降低 BCRL 风险的教育。