Study on the relationship between lymphedema stage and related symptoms in patients with breast cancer after surgery.

Abstract

Background: Breast cancer-related lymphedema (BCRL) seriously affects patients' quality of life. We aimed to understand the stage of postoperative lymphedema and the occurrence of related symptoms in breast cancer patients, and to analyze the relationship between the two, so as to provide reference for the implementation of targeted clinical interventions.

Methods: Convenience sampling method was used to select postoperative breast cancer patients attending the lymphedema evaluation clinic of a tertiary hospital in Shanghai for questionnaire survey. A professional lymphedema therapist assessed the severity of the patients' lymphedema according to the International Society of Lymphology (ISL) lymphedema grading criteria, and the Breast Cancer and Lymphedema Symptom Experience Index (BCLE-SEI) was used to assess the severity of the patients' lymphedema and patients' experience of lymphedema-related symptoms. This study aimed to understand the occurrence of lymphedema in breast cancer patients after surgery, and to explore the characteristics of related symptoms in patients with different stages of lymphedema.

Results: Of the 1,021 patients, 744 (72.86%) were in stage 0, 161 (11.36%) in stage 1, 98 (9.5%) in stage 2, and 18 (1.7%) in stage 3. The higher the lymphedema stage, the number and severity of symptoms significantly increased (P<0.001), with stage 2 and 3 patients reporting more symptoms and greater severity compared to stage 0 and 1 patients. In terms of symptom distress, the higher lymphedema stage was associated with a significant increase in the total symptom distress score as well as in the functional and emotional dimensions of distress (P<0.001).

Conclusions: The number of symptom presentations, symptom severity and their degree of distress increased with higher lymphedema stage. Attention should be paid to patients' symptom complaints, and early identification and timely intervention should be made in patients with stage 0 and 1 lymphedema to alleviate their symptoms and slow down the progression of edema.