163789 Arm swelling and psychological well-being among long-term breast cancer survivors

Monday, November 5, 2007: 1:15 PM

Jill M. Oliveri, MPH, DrPH , Comprehensive Cancer Center, The Ohio State University, Columbus, OH
Jeannette Day, MS , Cancer Statistical Center, Duke University Medical Center, Durham, NC
Catherine Alfano, PhD , Comprehensive Cancer Center, The Ohio State University, Columbus, OH
James E. Herndon II, PhD , Cancer Statistical Center, Duke University Medical Center, Durham, NC
Mira Katz, PhD , Comprehensive Cancer Center, The Ohio State University, Columbus, OH
Marisa Bittoni, MS , Comprehensive Cancer Center, The Ohio State University, Columbus, OH
Electra D. Paskett, PhD , School of Public Health, The Ohio State University, Columbus, OH
Purpose: Lymphedema is an under-reported and debilitating consequence of axillary node dissection among breast cancer survivors. This study describes the characteristics of arm and hand swelling and the effects of swelling on psychological well-being among a population of breast cancer survivors who participated in a clinical trial coordinated by the Cancer and Leukemia Group B (CALGB 8541) 9 16 years ago. Methods: 331eligible survivors of CALGB 8541 were contacted and asked to complete a mailed survey assessing questions about demographics, quality of life, arm/hand swelling, sexuality, breast cancer anxiety, spirituality, and depression. Results: Of the 245 women (mean age 61.9 years; 93% Caucasian; average 12.4 years post-diagnosis) who completed a survey, 75 (31%) reported arm/hand swelling since their surgery. Of these women, 76% reported current swelling, and half reported constant swelling, mainly in the upper arm. Self-reported swelling was either mild or moderate in 88% of the women. Women perceived the causes of their swelling to be removal of lymph nodes (73%) and general arm use (23%). Swelling interfered with wearing clothing (36%) and perceptions about general appearance (32%). Few women (37%) sought treatment for swelling. Swelling severity and interference with daily activities negatively affected physical functioning, however swelling showed little effect on psychological well-being. Conclusions: Arm/hand swelling is a significant problem for long-term survivors of breast cancer, negatively affecting physical well-being. These findings suggest that educational efforts to raise awareness about lymphedema are critical so that women may seek help early and may improve their health-related quality of life.

Learning Objectives:
1. Define lymphedema. 2. Describe the characteristics of arm and hand swelling among long-term breast cancer survivors. 3. Describe the relationship between lymphedema and health-related quality of life.

Keywords: Breast Cancer, Quality of Life

Presenting author's disclosure statement:

Any relevant financial relationships? No
Any institutionally-contracted trials related to this submission?

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.