Lymphedema Knowledge Weak Among Breast Cancer Patients

Dorothy N. Pierce, DNP, MSN, RN, NP-C, CRN, OCN, CBCN Advanced Practice Nurse Rutgers Cancer Institute of New Jersey Rutgers, The State University of New Jersey New Brunswick, NJ Interview With
Dorothy N. Pierce, DNP, MSN, RN, NP-C, CRN, OCN, CBCN
Advanced Practice Nurse
Rutgers Cancer Institute of New Jersey
Rutgers, The State University of New Jersey
New Brunswick, NJ  08901

MedicalResearch: What are the main findings of the study?

Answer: The main findings from the study were:

  1. Nineteen patients out of 24 (79%) reported lymphedema (LE) symptoms. Majority reporting symptoms received chemotherapy and were 50 years of age and older.
  2. The most commonly reported symptoms were limb tenderness (n=10), swelling (n=9), firmness/tightness (n=8), numbness (n=6), heaviness (n=5), impaired movement of the shoulder (n=5), and finger (n=4).
  3. Overall, the participants had low to moderate lymphedema knowledge. The mean knowledge score was 11.9 with a range from zero to 20.
  4. Patients beginning radiation therapy for breast cancer often had not received any lymphedema information from health care providers prior to therapy; Lymphedema knowledge is moderate to weak.

MedicalResearch: Was any of the findings unexpected?

Answer: It was astonishing that only eight patients out of 24 patients (33%) received any information concerning lymphedema from their healthcare professional. The striking fact that caught my attention was that only one patient received lymphedema information from a nurse.

MedicalResearch: What should clinicians and patients take away from your report?

Answer: Any individual diagnosed with breast cancer (BC) will experience a difficult obstacle, and it is imperative to know the potential complications of treatment, such as lymphedema. Advanced Practice Nurses play a critical role in educating patients about the risk of breast cancer related lymphedema (BCRL) a side effect that may develop after treatment intervention. Patients should be aware of early identification, prevention, and management of complication is imperative. These patients should learn how to reduce their risk early by implementation of written guidelines, educational session on how to reduce their risk of lymphedema, preventing complications should it occur. Collaboration with other specialists for evaluation is essential. It is critical for radiation clinician to maintain open communication with patients and the multidisciplinary healthcare team.

MedicalResearch: What recommendations do you have for future research because of this study?

Answer: Unfortunately, little research was found in the literature about the outcomes of breast cancer related lymphedema, particularly in the radiation oncology setting. To my knowledge, this is the first study to examine patients’ breast cancer related lymphedema knowledge and self-reported symptoms among patients receiving radiation therapy. With all that has been identified about lymphedema knowledge and symptoms some questions still linger. More research evaluating whether specific symptoms attributes to breast cancer related lymphedema are truly less common among breast cancer patients pre radiation rather than during radiation will help clarify whether these symptoms are related to radiation. Because this research has not supported increase symptoms in patients at risk for breast cancer related lymphedema, studies investigating symptoms during radiation is needed.

This study has been extended to recruit more patients and follow the patients for a longer period. In addition, future research should consider for replication of this study at multiple radiation oncology sites in various geographic locations across the United States. In addition, this information can be utilized to establish a provider assessment protocol (including patient assessment and patient education).


American Association of Nurse Practitioners Abstract June 17-21, 2014

Pierce D, et al: Lymphedema Knowledge and Symptoms in Breast Cancer Patients Receiving Radiation Therapy



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