Quality of life and the level of knowledge and utilization of lymphedema prevention principles among mastectomized patients
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Introduction: Breast cancer is the most prevalent female malignancy in Poland. Oncological treatment and its adverse effects diminish quality of life of breast cancer patients, which is determined by a number of somatic, psychological and social factors. Purpose: To assess the quality of life and the level of knowledge and utilization of lymphedema prevention principles among women after surgical treatment of breast cancer. Materials and methods: The study included 145 breast cancer patients after radical mastectomy. The respondents were examined with the validated EORTC QLQ-BR23 questionnaire and a custom-designed survey. Results: Examination with the QLQ-BR23 questionnaire revealed that mastectomized women scored low on the body image scale. The most frequently reported ailments were arm and breast symptoms. While the respondents showed high level of knowledge with regards to lymphedema prevention, they poorly adhered to the prophylactic guidelines. The participants were well aware of the risk factors of lymphedema, and most of them declared avoidance of their harmful effects. Conclusions: Quality of life assessment should constitute an integral component of rehabilitation in every breast cancer patient, as mastectomy exerts significant effect on the outcome of perioperative period. Apart from specialist physiotherapy, also education of patients with regards to principles of lymphedema prevention and autotherapy constitutes an important component of complex management of lymphatic insufficiency.
- National Cancer Registry 2010, http://onkologia.org.pl/nowotwory-piersi-kobiet/, Accessed on February 2nd, 2014. (Polish)
- Albain KS, Barlow WE, Shak S, Hortobagyi GN, Livingston RB, Yeh IT, Ravdin P, Bugarini R, Baehner FL, Davidson NE. et al. Breast Cancer Intergroup of North America. Prognostic and predictive value of the 21-gene recurrence score assay in postmenopausal women with node-positive, oestrogen-receptor-positive breast cancer on chemotherapy: a retrospective analysis of a randomised trial. Lancet Oncol. 2010 Jan;11(1):55-65.
- Antoniou AC, Hardy R, Walker L, Evans DG, Shenton A, Eeles R, Shanley S, Pichert G, Izatt L, Rose S, Douglas F, Eccles D, Morrison PJ, Scott J, Zimmern RL, Easton DF, Pharoah PD. Predicting the likelihood of carrying a BRCA1 or BRCA2 mutation: validation of BOADICEA, BRCAPRO, IBIS, Myriad and the Manchester scoring system using data from UK genetics clinics. J Med Genet. 2008 Jul;45(7):425-31.
- Veronesi U, Stafyla V, Petit JY, Veronesi P. Conservative mastectomy: extending the idea of breast conservation. Lancet Oncol. 2012 Jul; 13(7):e311-7.
- Hoffman KE, Mittendorf EA, Buchholz TA. Optimising radiation treatment decisions for patients who receive neoadjuvant chemotherapy and mastectomy. Lancet Oncol. 2012 Jun; 13(6):e270-6.
- Koukourakis G. Radiation therapy for early breast cancer. Clin Transl Oncol. 2009; 11(9):596-603.
- Bianchini G, Gianni L. The immune system and response to HER2-targeted treatment in breast cancer. Lancet Oncol. 2014 Feb;15(2):e58-68.
- Cuzick J, Sestak I, Bonanni B, Costantino JP, Cummings S, DeCensi A, Dowsett M, Forbes JF, Ford L, LaCroix AZ, Mershon J, Mitlak BH, Powles T, Veronesi U, Vogel V, Wickerham DL. SERM Chemoprevention of Breast Cancer Overview Group. Selective oestrogen receptor modulators in prevention of breast cancer: an updated meta-analysis of individual participant data. Lancet. 2013 May 25; 381(9880):1827-34.
- Oostendorp LJ, Stalmeier PF, Donders AR, van der Graaf WT, Ottevanger PB. Efficacy and safety of palliative chemotherapy for patients with advanced breast cancer pretreated with anthracyclines and taxanes: a systematic review. Lancet Oncol. 2011 Oct;12(11):1053-61.
- Krzakowski M, Warzocha K. (ed.) Diagnostic and therapeutic recommendations in mali-gnancies 2013. VM Media sp. z.o.o VM Group sp.k., Gdańsk 2013. (Polish)
- Dodwell D, Thorpe H, Coleman R. Refining systemic therapy for early breast cancer: difficulties with subtraction. Lancet Oncol. 2009 Aug;10(8):738-9.
- DiSipio T, Rye S, Newman B, Hayes S. Incidence of unilateral arm lymphoedema after breast cancer: a systematic review and meta-analysis. Lancet Oncol. 2013 May;14(6):500-15.
- Huang TW, Tseng SH, Lin CC, Bai CH, Chen CS, Hung CS, Wu CH, Tam KW. Effects of manual lymphatic drainage on breast cancer-related lymphedema: a systematic review and meta-analysis of randomized controlled trials. World J Surg Oncol. 2013 Jan 24;11:15.
- Devoogdt N, Van Kampen M, Geraerts I, Coremans T, Christiaens MR. Different physical treatment modalities for lymphoedema developing after axillary lymph node dissection for breast cancer: a review. Eur J Obstet Gynecol Reprod Biol. 2010 Mar;149(1):3-9.
- Korpan MI, Crevenna R, Fialka-Moser V. Lymphedema: a therapeutic approach in the treatment and rehabilitation of cancer patients. Am J Phys Med Rehabil. 2011 May; 90(5 Suppl 1):S69-75.
- McNeely ML, Campbell KL, Courneya KS, Mackey JR. Effect of acute exercise on upper-limb volume in breast cancer survivors: a pilot study. Physiother Can. 2009 Fall; 61(4):244-51.
- Norman SA, Localio AR, Potashnik SL, Simoes Torpey HA, Kallan MJ, Weber AL, Miller LT, Demichele A, Solin LJ. Lymphedema in breast cancer survivors: incidence, degree, time course, treatment, and symptoms. J Clin Oncol. 2009 Jan 20;27(3):390-7.
- Han J, Grothuesmann D, Neises M, Hille U, Hillemanns P. Quality of life and satisfaction after breast cancer operation. Arch Gynecol Obstet. 2010 Jul;282(1):75-82.
- Kaviani A, Sodagari N, Sheikhbahaei S, Eslami V, Hafezi-Nejad N, Safavi A, Noparast M, Fitoussi A. From Radical Mastectomy to Breast-Conserving Therapy and Oncoplastic Breast Surgery: A Narrative Review Comparing Oncological Result, Cosmetic Outcome, Quality of Life, and Health Economy. ISRN Oncol. 2013 Sep 12; 2013:742462. eCollection 2013.
- Hopwood P, Haviland J, Mills J, Sumo G, M Bliss J; START Trial Management Group. The impact of age and clinical factors on quality of life in early breast cancer: an analysis of 2208 women recruited to the UK START Trial (Standardisation of Breast Radiotherapy Trial). Breast. 2007 Jun;16(3):241-51.
- Arraras JI, Manterola A, Domínguez MA, Arias F, Villafranca E, Romero P, Martínez E, Illarramendi JJ, Salgado E. Impact of radiotherapy on the quality of life of elderly patients with localized breast cancer. A prospective study. Clin Transl Oncol. 2008 Aug;10(8):498-504.
- Browall MM, Ahlberg KM, Persson LO, Karlsson PO, Danielson EB. The impact of age on Health-Related Quality of Life (HRQoL) and symptoms among postmenopausal women with breast cancer receiving adjuvant chemotherapy. Acta Oncol. 2008;47(2):207-215.
- Fehlauer F, Tribius S, Mehnert A, Rades D. Health-related quality of life in long term breast cancer survivors treated with breast conserving therapy: impact of age at therapy. Breast Cancer Res Treat. 2005 Aug; 92(3):217-22.
- Piątek J, Krauss H, Gaik M, Krawczyk J, Sajdak S. Quality of life in mastectomized women. Przegl Ginekol Położ. 2004;4:173-7. (Polish)
- Tomalska J, Trytko A, Ogarek D, Schmidt J, Bibro M, Łaczek-Wójtowicz M, Wódka K. Assessment of the quality of life in women after surgical treatment of breast cancer, being the members of Amazonki clubs. Pielęg XXI wieku 2012;4(41):85-9. (Polish)
- Ridan T, Sleczkowska J, Sobota M, Ochalek K. Evaluation of breast cancer prevention and quality of life by women after single breast mastectomy, grouped in the Amazons postmastectomy women`s club. Zdr Publ. 2001; 121(1):32-6. (Polish)
- Tasiemski T., Kujawa M., Pokaczajło J. Quality of life of women after mastectomy Physiotherapy. 2009; 17(4): 48-58.
- International Society of Lymphology. The diagnosis and treatment of peripheral lymphedema: 2013 Consensus Document of the International Society of Lymphology. Lymphology. 2013 Mar;46(1):1-11.
- Sagen A, Kåresen R, Risberg MA. Physical activity for the affected limb and arm lymphedema after breast cancer surgery: A prospective, randomized controlled trial with two years follow-up. Acta Oncol. 2009; 48:1102-10.
- Pyszora A, Graczyk M, Krajnik M, Doś J. Implementation of modified manual lympho-edema treatment-complex physical therapy (MLT-CPT) in terminally ill patient. Adv Pall Med. 2007;6:93-5.
- Zuther E. Lymphedema management: the comprehensive guide for practitioners. Thieme Medical Publishers, New York 2005: p.218-22.
- Golshan M, Smith B. Prevention and management of arm lymphedema in the patient with breast cancer. J Support Oncol. 2006 Sep;4(8):381-6.
- Pyszora A, Adamowska A, Krajnik M. The problems of patients with lymphoedema. Pilot study of breast cancer survivors. Adv Pall Med. 2009; 3:10-106. (Polish)
- Grądalski T, Ochałek K. Principles of pathophysiology and management of lymphedema associated with malignant disease. Nowa Medycyna. 2001;97:55-8. (Polish)
- Bosompra K, Ashikaga T, O'Brien PJ, Nelson L, Skelly J, Beatty DJ. Knowledge about preventing and managing lymphedema: a survey of recently diagnosed and treated breast cancer patients. Patient Educ Couns. 2002 Jun; 47(2):155-63.
- Dziura I, Grądalski T. Knowledge of etiological factors of lymphedema and adherence to prophylactic recommendations among mastectomized patients. Rehabil Med. 2008; 4:23-7.
- Moseley AL, Piller NB, Carati CJ. The effect of gentle arm exercise and deep breathing on secondary arm lymphedema. Lymphology. 2005 Sep; 38(3):136-45.
- de Godoy JM, de Godoy MF, Valente A, Camacho EL, Paiva EV. Lympho-scintigraphic evaluation in patients after erysipelas. Lymphology. 2000 Dec; 33(4):177-80.
- Shaw C, Mortimer P, Judd PA. A randomized controlled trial of weight reduction as a treatment for breast cancer-related lymphedema. Cancer. 2007 Oct 15;110(8):1868-74.
- Soran A, D'Angelo G, Begovic M, Ardic F, Harlak A, Samuel Wieand H, Vogel VG, Johnson RR. Breast cancer-related lymphedema-what are the significant predictors and how they affect the severity of lymphedema? Breast J. 2006 Nov-Dec; 12(6):536-43.
- Mathews M, Bursey G, Park A, Hodgson P, West P, Church J. Increasing public and provider knowledge of lymphedema: evaluation of the lymphedema roadshow. J Cancer Educ. 2007 Summer; 22(2):105-7.
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