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Association Between Lymphedema Self-Care Adherence and Lymphedema Outcomes Among Women with Breast Cancer-Related Lymphedema

Brown, Justin C., MA; Kumar, Anagha, AB; Cheville, Andrea L., MD, MSCE; Tchou, Julia C., MD, PhD; Troxel, Andrea B., ScD; Harris, Susan R., PT, PhD; Schmitz, Kathryn H., PhD, MPH

American Journal of Physical Medicine & Rehabilitation: April 2015 - Volume 94 - Issue 4 - p 288–296
doi: 10.1097/PHM.0000000000000178
Original Research Articles
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Objective The aim of this study was to determine whether adherence to self-care modalities for breast cancer-related lymphedema (BCRL) predicts BCRL outcomes among 128 breast cancer survivors who participated in the 12-mo physical activity and lymphedema trial.

Design This was a prospective cohort study. Adherence to ten BCRL self-care modalities, as recommended in the clinical practice guidelines for the management of BCRL, was assessed by a questionnaire at baseline. BCRL outcomes assessed at baseline and 12 mos included volumetry, circumferences, bioimpedence spectroscopy, the Norman lymphedema survey, and therapist-defined lymphedema exacerbations requiring treatment. Generalized linear models were used to estimate the relationship between adherence to BCRL self-care modalities and the likelihood of experiencing a BCRL outcome.

Results Adherence to BCRL self-care activities did not predict experiencing any BCRL outcomes at 12 mos. Levels of adherence to BCRL self-care modalities did not predict a 5% or greater decrease in interlimb volume (Ptrend = 0.79), 5% or greater decrease in the sum of interlimb arm circumferences (Ptrend = 0.47), 10% or greater decrease in bioimpedence spectroscopy (Ptrend = 0.83), 1 or greater decrease in self-reported lymphedema symptoms (Ptrend = 0.91), or therapist-defined lymphedema exacerbation requiring treatment (Ptrend = 0.84).

Conclusions Our findings suggest that levels of BCRL self-care adherence do not predict BCRL outcomes among breast cancer survivors with stable lymphedema who were followed for 12 mos.

From the University of Pennsylvania, Philadelphia, Pennsylvania (JCB, AK, JCT, ABT, KHS); Mayo Clinic, Rochester, Minnesota (ALC); and University of British Columbia, Vancouver, British Columbia, Canada (SRH).

All correspondence and requests for reprints should be addressed to: Kathryn H. Schmitz, PhD, MPH, University of Pennsylvania School of Medicine, 423 Guardian Drive, 8th Floor, Blockley Hall, Philadelphia, PA 19104.

Supported by the BSN Medical by providing custom-fitted compression garments to all study participants.

Financial disclosure statements have been obtained, and no conflicts of interest have been reported by the authors or by any individuals in control of the content of this article.

Copyright © 2015 Wolters Kluwer Health, Inc. All rights reserved.