Nursing and Obstetrics Faculty, Universidad Juárez del Estado de Durango, Durango, Durango, Mexico.
Statal Center for Cancerology, Secretaria de Salud Durango, Durango, Durango, Mexico.
Support Care Cancer. 2024 Oct 8;32(11):713. doi: 10.1007/s00520-024-08895-4.
To assess whether health-related quality of life (HRQOL) improved through a postmastectomy care program focused on breast cancer-related lymphedema (BCRL) protection/awareness.
Postoperative breast cancer patients were enrolled prospectively (February-2018 to September-2019) at Nursing and Obstetrics Faculty, Durango, Mexico. Sociodemographic/clinical characteristics, arm measurements, and HRQOL evaluation with Functional Assessment Cancer Therapy-Breast Cancer were collected at baseline and after six follow-up assessments between six-to-twelve-month postmastectomy. Lymphedema was verified through circometry. Descriptive analysis and McNemar-Bowker test were used to evaluate paired differences in HRQOL. Subgroup analysis was conducted to assess sociodemographic/clinical characteristics of BCRL using Pearson's chi-squared or Fisher exact test along with odds ratios (OR) and 95% confidence intervals (CI). All tests were two-sided with P-values < 0.05 considered statistically significant.
One-hundred-two patients developed BCRL (incidence 66.2%, n = 154). All dimensions of HRQOL improved after the postmastectomy care program (P < 0.05). The subgroup analysis indicated that elementary academic degree (OR = 2.40, 95%CI: 1.01-5.69), laborer (OR = 9.85, 95%CI: 3.30-29.3), and total mastectomy (OR = 4.23, 95%CI: 1.20-14.9) were more associated with BCRL (P < 0.05). Conversely, high school academic degree (OR = 0.46, 95%CI: 0.22-0.94), married status (OR = 0.42, 95%CI: 0.21-0.86), housewife (OR = 0.27, 95%CI: 0.12-0.61), professional occupation (OR = 0.10, 95%CI: 0.01-0.64), and having no comorbidities (OR = 0.31, 95%CI: 0.15-0.63) were less associated with BCRL (P < 0.05).
Although HRQOL improved through the postmastectomy care program, our findings suggest that lower education, working as a laborer, and total mastectomy may be more associated with BCRL. Continuing research may uncover liabilities among BCRL patients within limited-resources settings.
评估以乳腺癌相关淋巴水肿（BCRL）保护/意识为重点的乳腺癌根治术后护理方案是否改善了健康相关生活质量（HRQOL）。
在墨西哥杜兰戈护理和妇产科学院，前瞻性地招募了术后乳腺癌患者（2018 年 2 月至 2019 年 9 月）。在乳腺癌根治术后 6 至 12 个月的 6 次随访评估中，收集了社会人口统计学/临床特征、手臂测量和 HRQOL 评估，采用功能性评估癌症治疗-乳腺癌。通过周径测量法验证淋巴水肿。使用描述性分析和 McNemar-Bowker 检验评估 HRQOL 的配对差异。使用 Pearson 卡方检验或 Fisher 确切检验以及比值比（OR）和 95%置信区间（CI）对 BCRL 的社会人口统计学/临床特征进行亚组分析。所有检验均为双侧，P 值<0.05 被认为具有统计学意义。
102 例患者发生 BCRL（发生率 66.2%，n=154）。乳腺癌根治术后所有 HRQOL 维度均有所改善（P<0.05）。亚组分析表明，小学学历（OR=2.40，95%CI：1.01-5.69）、体力劳动者（OR=9.85，95%CI：3.30-29.3）和全乳切除术（OR=4.23，95%CI：1.20-14.9）与 BCRL 更相关（P<0.05）。相反，高中学历（OR=0.46，95%CI：0.22-0.94）、已婚状态（OR=0.42，95%CI：0.21-0.86）、家庭主妇（OR=0.27，95%CI：0.12-0.61）、专业职业（OR=0.10，95%CI：0.01-0.64）和无合并症（OR=0.31，95%CI：0.15-0.63）与 BCRL 相关性较低（P<0.05）。
尽管乳腺癌根治术后护理方案改善了 HRQOL，但我们的研究结果表明，较低的教育水平、体力劳动和全乳切除术可能与 BCRL 更相关。在资源有限的环境中，进一步的研究可能会发现 BCRL 患者的缺陷。
