Abstract
ABSTRACT Objective: To identify the profile of women with lymphedema after breast cancer treatment. Methods: This is a descriptive, retrospective and quantitative study with data from medical records of women with lymphedema who began treatment between 2010 and 2015 in a rehabilitation center. An instrument was used for data collection to characterize the participants and analysis was performed by means of descriptive statistics, the Chi-Square test and Fisher’s exact test. Results: 235 women with a mean age of 56.8 years were included, with an association between lymphedema and age (p = 0.016). It was observed that 76.6% of the sample had some comorbidity associated with breast cancer, especially hypertension (48.1%). They underwent radical surgery (60%), axillary lymphadenectomy (77.9%), sentinel lymph node biopsy (16.6%) and radiotherapy (74%). Treatments carried out for lymphedema were decongestant therapy and complementary treatments with 95.7% of adherence of women to therapies. Conclusion and implications for practice: Women with lymphedema presented risk factors such as radical surgery, axillary lymphadenectomy and radiotherapy, and good adherence to the required treatments of lymphedema. Knowing the profile of this population is crucial to the treatment choice.
Highlights
As cancer treatments progress, there is increased concern with the quality of life of patients, and one of the greatest complications of breast cancer is lymphedema. 1.2Breast cancer-related lymphedema is defined as a chronic and progressive disease, as shown in a prospective cohort study carried out with 964 women with breast cancer.The lymphedema cumulative incidence observed was 13.5% after two years of follow-up, 30.2% after five years, reaching 41.1% after 10 years. 3The cause of lymphedema is the abnormal lymph build up in the interstitial space
A BMI between overweight and obesity (≥ 25 kg/m) was observed in 78.4% of women with lymphedema, which is line with the literature that points out to overweight or obesity as a risk factor for lymphedema.1, 6, 14An observational study carried out with 100 women investigated the prevalence of lymphedema in overweight or obese women who underwent mastectomy and it found that overweight women are twice as likely to have lymphedema, and for those who have level 1 obesity, the risk of developing this comorbidity is around six times higher.[6]
Systemic arterial hypertension is a very much prevalent condition, found in 48.1% of women of this study.These data are confirmed by a systematic review of the literature, which found that women with breast cancer and arterial hypertension have an increased risk of 1.83 times for the development of lymphedema compared to those who do not have these conditions.[16]
Summary
There is increased concern with the quality of life of patients, and one of the greatest complications of breast cancer is lymphedema. 3. The cause of lymphedema is the abnormal lymph build up in the interstitial space. The cause of lymphedema is the abnormal lymph build up in the interstitial space This build up is the result of a lymph system failure in the homolateral limb, generally triggered by surgical procedures and/or radiotherapy in the axillary region. Most women with breast cancer-related lymphedema have altered mobility in the affected limb, making daily activities and routine more difficult. In this context, it is essential to identify common characteristics in women who have breast cancer-related lymphedema to improve prevention and handling of this comorbidity by health professionals, aiming at a better quality of life for this population. In addition to the loss of physical functions, lymphedema leads to fear of worsening of the condition and changes in the body image perception, resulting in a downturn of emotional and psychosocial aspects, such as low self-esteem, anxiety and depression, all of which affect interpersonal relationships. 8-10
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