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Learning Objective 1: The learner will be able to relate increased awareness of evidence-based research concerning the risk of developing lymphedema after breast cancer surgery.
Learning Objective 2: The learner will be able to detail the importance of early identification and treatment of lymphedema to minimize and control progression of tissue damage.
Purpose: To develop a standardized protocol based on evidence-based research for healthcare providers to educate and assess breast cancer patients who undergo surgical intervention concerning their risk for developing breast cancer-related lymphedema. Background: Studies show that as many as 50% of breast cancer patients that develop lymphedema were not given pre-treatment information with respect to their risk for developing lymphedema. An additional identified gap in the literature is that breast cancer patients are not being assessed routinely either objectively or through self-reported symptoms. This identified gap in education and assessment was present in a rural clinic treating breast cancer patients and implementation of a standardized protocol to address these gaps was the focus of this study. Method: Over an eight month period, fourteen women who were diagnosed with Stage I – III breast cancer and underwent surgical intervention were involved in the study. Healthcare providers initiated preoperative education and physical assessments including bilateral baseline arm circumference measurements and body mass index determination. At each subsequent visit, physical measurements were repeated and compared to previous findings. Knowledge of and compliance with risk reduction behaviors were assessed based on the Lymphedema Knowledge Scale (LKS) and the Lymphedema Risk—Reduction Behavior Checklist (LRRB). Results: Three of the fourteen women (21%) developed signs and symptoms of lymphedema. These women were referred to lymphedema specialists and physical therapists for intervention as outlined in the established protocol for the practice. Impact: Early detection and intervention hold the greatest promise of reducing the incidence of breast cancer-related lymphedema. When patients are provided knowledge concerning their risk of developing possible treatment related complications they are empowered and can utilize self-efficacy skills to impact their quality of life in a positive direction.
Keywords: breast cancer, lymphedema, risk reduction, early detection