The Factors Associated with Breast Cancer – Related Lymphedema Following Breast Surgery with Lymph Node Dissection

Abstract

Purpose: To study the factors associated with breast cancer-related lymphedema among breast cancer patients after breast surgery with lymph node dissection.

Design: Descriptive correlation research

Method: The sample consisted of 148 breast cancer patients who underwent breast surgery with lymph node dissection for 1 year or more and visited 3 tertiary hospitals of the 4^th health service region in Thailand. Purposive sampling was used. Data were collected by 4 questionnaires including, 1) demographic characteristic, 2) Lymphedema and Breast Cancer Questionnaire.3) receiving arm lymphedema information, and 4) lymphedema risk-reduction behavior. All questionnaires had content validity. The Cronbach’s alpha coefficients of the 2^nd-4^th questionnaires were .88, .82 and, .88 respectively. Arm circumference was measured at 6 points in two arms. The difference at > 2 cm in any point used to determine the arm lymphedema. Data were analyzed by using descriptive statistics, the point biserial correlation coefficients, chi-square and, Fisher exact tests.

Finding: The sample had a mean age of 59.52 years. (S.D.=11.22), The majority of them had breast cancer stage 2. (43.2%), The average postoperative period was 4.44 years. (S.D.=3.58), arm lymphedema was found in 51 cases (34.5 %). The factors that were associated with breast cancer – related lymphedema were radiotherapy (²=15.37_, p < 0.001), surgery type (²=10.28, p < 0.05), and the overall score for risk reduction behaviors (r_pb= -0.298,p< 0.001). Moreover, the symptoms reported were significantly associated with arm lymphedema (r_pb = 0.577, p < 0.001).

Conclusion: Surgery type and radiotherapy were correlated with arm lymphedema. Therefore, appropriate nursing care to preventing arm lymphedema should be applied in this group of patients. Especially, promoting self-care behavior to reduce the risk of arm lymphedema together with assessing symptoms associated with arm lymphedema.