Lymphedema therapy referral is associated with improved understanding of lymphedema prevention among breast cancer survivors.

Abstract

12069 Background: Lymphedema is common among breast cancer survivors (BCS) and negatively affects quality of life. There are modifiable factors to reduce lymphedema risk and exacerbation; it is unknown how aware survivors are of these factors. We hypothesized referral to lymphedema therapy (LT) to be associated with improved lymphedema knowledge. Methods: BCS were approached during follow-up visits at an NCI-designated cancer center between 2014-2015 and asked to complete an anonymous survey. Eligibility criteria: age ≥18, English-speaking, > 6 months post-surgery, no cancer recurrence, no prior or subsequent second cancer. Surveys included 10 true/false questions to assess beliefs of common lymphedema misconceptions and questions about sociodemographics, cancer treatment, and prior LT referral. Charts were reviewed to determine history of axillary lymph node dissection (ALND) or sentinel node biopsy (SLNB). Multivariable logistic regression assessed the relationship between prior LT referral and correctly answering questions about lymphedema misconceptions. Results: Of 209 participants, 67% identified as non-Latinx white, 13% Black, 10% Latinx and 8% Asian. 53 (25%) had been referred to LT. Those who had SLNB were less frequently referred to LT [15 (14%)] than those who had ALND [38 (39%)]. There were 5 lymphedema knowledge questions with < 80% correct responses (Table). Those previously referred to LT more often correctly answered the questions about weight gain and using the arm on an airplane than those not referred (chi-2: p <0.01 and p < 0.01), but they were less likely to answer correctly about carrying > 10 lbs or strenuous activity at work (p < 0.01 and p = 0.02, respectively) (Table). These associations remained in multivariable analyses, other than strenuous work activity (Table). Conclusions: We identified several misconceptions regarding lymphedema among BCS. LT referral is a potential opportunity to debunk common misunderstandings regarding lymphedema risk reduction; providers should have a low threshold to refer patients. Lymphedema therapists teach progressive exercise strategies, which may have inadvertently caused participants to think they should avoid carrying objects > 10 lbs.[Table: see text]