Li Yun, Ma Yan, Hou Shengqun, Zhang Xia, Chen Yaqiong, Ma Youman, Tang Lichen, Zhang Xiaoju, Lu Zhenqi, Qiu Jiajia
Department of Nursing Administration, Fudan University Shanghai Cancer Center, Shanghai, China.
Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China.
Gland Surg. 2025 Mar 31;14(3):358-367. doi: 10.21037/gs-2024-536. Epub 2025 Mar 26.
Breast cancer-related lymphedema (BCRL) seriously affects patients' quality of life. We aimed to understand the stage of postoperative lymphedema and the occurrence of related symptoms in breast cancer patients, and to analyze the relationship between the two, so as to provide reference for the implementation of targeted clinical interventions.
Convenience sampling method was used to select postoperative breast cancer patients attending the lymphedema evaluation clinic of a tertiary hospital in Shanghai for questionnaire survey. A professional lymphedema therapist assessed the severity of the patients' lymphedema according to the International Society of Lymphology (ISL) lymphedema grading criteria, and the Breast Cancer and Lymphedema Symptom Experience Index (BCLE-SEI) was used to assess the severity of the patients' lymphedema and patients' experience of lymphedema-related symptoms. This study aimed to understand the occurrence of lymphedema in breast cancer patients after surgery, and to explore the characteristics of related symptoms in patients with different stages of lymphedema.
Of the 1,021 patients, 744 (72.86%) were in stage 0, 161 (11.36%) in stage 1, 98 (9.5%) in stage 2, and 18 (1.7%) in stage 3. The higher the lymphedema stage, the number and severity of symptoms significantly increased (P<0.001), with stage 2 and 3 patients reporting more symptoms and greater severity compared to stage 0 and 1 patients. In terms of symptom distress, the higher lymphedema stage was associated with a significant increase in the total symptom distress score as well as in the functional and emotional dimensions of distress (P<0.001).
The number of symptom presentations, symptom severity and their degree of distress increased with higher lymphedema stage. Attention should be paid to patients' symptom complaints, and early identification and timely intervention should be made in patients with stage 0 and 1 lymphedema to alleviate their symptoms and slow down the progression of edema.
乳腺癌相关淋巴水肿(BCRL)严重影响患者的生活质量。我们旨在了解乳腺癌患者术后淋巴水肿的阶段以及相关症状的发生情况,并分析两者之间的关系,以便为实施有针对性的临床干预提供参考。
采用便利抽样法,选取上海市某三级医院淋巴水肿评估门诊的乳腺癌术后患者进行问卷调查。由专业的淋巴水肿治疗师根据国际淋巴学会(ISL)淋巴水肿分级标准评估患者淋巴水肿的严重程度,并采用乳腺癌与淋巴水肿症状体验指数(BCLE-SEI)评估患者淋巴水肿的严重程度以及患者对淋巴水肿相关症状的体验。本研究旨在了解乳腺癌患者术后淋巴水肿的发生情况,并探讨不同阶段淋巴水肿患者相关症状的特点。
在1021例患者中,0期744例(72.86%),1期161例(11.36%),2期98例(9.5%),3期18例(1.7%)。淋巴水肿阶段越高,症状的数量和严重程度显著增加(P<0.001),与0期和1期患者相比,2期和3期患者报告的症状更多且严重程度更高。在症状困扰方面,淋巴水肿阶段越高,总症状困扰评分以及困扰的功能和情感维度显著增加(P<0.001)。
随着淋巴水肿阶段的升高,症状表现的数量、症状严重程度及其困扰程度均增加。应关注患者的症状主诉,对0期和1期淋巴水肿患者进行早期识别并及时干预,以减轻其症状并减缓水肿进展。