Department of Surgery, Wayne State University School of Medicine, Detroit, MI; Karmanos Cancer Institute, Wayne State University, Detroit, MI.
Department of Surgery, Wayne State University School of Medicine, Detroit, MI; Karmanos Cancer Institute, Wayne State University, Detroit, MI.
Surgery. 2019 Oct;166(4):686-690. doi: 10.1016/j.surg.2019.05.048. Epub 2019 Aug 29.
Certain treatments increase lymphedema risk in breast cancer survivors. The purpose of this study was to determine whether quality of life improved with preoperative teaching by a lymphedema expert.
Preoperative breast cancer patients were prospectively randomized into intervention group 1 or control group 2. Group 1 had a discussion with the lymphedema expert and at 6 months, in addition to the preoperative surgical discussion and literature given to all. Arm measurements and quality of life evaluation with Functional Assessment of Cancer Therapy-Breast Cancer were completed preoperatively and at intervals for up to 3 years. Lymphedema was verified with a 10% increase in volume or circumference. Univariate and multivariate analysis were performed on data.
There were 119 evaluable patients with no differences between groups 1 and 2. The rate of acute lymphedema was 51.5% (33 of 64) for group 1 and 47.2% (26 of 55) for group 2. Chronic lymphedema presented in 13 patients (9.3% group 1 and 12.7% group 2). Lymphedema was significantly associated with number of lymph nodes resected (P < .001). Significant findings in the Functional Assessment of Cancer Therapy-Breast Cancer were at 6 months for all and after diagnosis in lymphedema positive patients.
Structured lymphedema teaching can help to improve quality of life in lymphedema patients.
某些治疗方法会增加乳腺癌幸存者的淋巴水肿风险。本研究的目的是确定术前由淋巴水肿专家进行教学是否能提高生活质量。
前瞻性随机将术前乳腺癌患者分为干预组 1 或对照组 2。组 1 与淋巴水肿专家进行讨论，除了术前手术讨论和所有患者都给予的文献外，还在 6 个月时进行。术前和最多 3 年内的间隔进行手臂测量和癌症治疗-乳腺癌功能评估的生活质量评估。淋巴水肿通过体积或周长增加 10%来验证。对数据进行单变量和多变量分析。
有 119 例可评估患者，组 1 和组 2 之间无差异。组 1 的急性淋巴水肿发生率为 51.5%（64 例中的 33 例），组 2 为 47.2%（55 例中的 26 例）。13 例患者出现慢性淋巴水肿（组 1 为 9.3%，组 2 为 12.7%）。淋巴水肿与切除的淋巴结数量显著相关（P<.001）。在所有患者中，6 个月时和在淋巴水肿阳性患者诊断后，癌症治疗-乳腺癌功能评估都有显著发现。
结构化的淋巴水肿教学可以帮助淋巴水肿患者提高生活质量。
