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Knowledge of the factors inducing lymphedema and compliance with preventive recommendations in mastectomy patients

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Dziura I., Grądalski T.
Medical Rehabilitation
|
2008
|
vol. 12(4)
23-27
EN
Background: Lymphedema is a clinical manifestation of lymphatic system insufficiency. The risk of lymphedema increases especially in the case of women after mastectomy with removal of axilla lymph nodes and post-surgical radiotherapy. As a result of the above, it appears in the upper limb at the side where the surgery has been carried out. The factors that increase the risk of lymphedema include fatigue, overheating and injury to the limb at risk.Aim: To investigate the level of awareness of lymphedema prevention and the frequency of the post-mastectomy patients’ compliance with the received recommendations.Material and methods: 40 women after one-side radical mastectomy and post-surgical radiotherapy took part in the research. None of them had symptoms of recurrence. All patients had a clinical manifestation of upper limb lymphedema at the side of the surgical intervention. The patients were asked to fill in a questionnaire that consisted of 6 questions.Results: The research has shown that patients with risk of lymphedema display a low level of education in the matter and that they indicate problems with access to professional information on the topic of lymphedema prevention. The properly trained medical staff rarely proved to be a source of information on the topic. The women who participated in the survey mostly knew that they had to avoid injections and taking blood pressure in the affected upper limb as well as excessive upper limb exercise. Most frequently mentioned preventive recommendations included elevation of the limb and appropriate exercise. Among the factors generating lymphedema, most women indicated excessive physical effort as a subjective cause of the manifestation of the condition.Conclusion: Despite the knowledge of lymphedema prevention measures, the patients often fail to comply with the recommendations they have been given.Background: Lymphedema is a clinical manifestation of lymphatic system insufficiency. The risk of lymphedema increases especially in the case of women after mastectomy with removal of axilla lymph nodes and post-surgical radiotherapy. As a result of the above, it appears in the upper limb at the side where the surgery has been carried out. The factors that increase the risk of lymphedema include fatigue, overheating and injury to the limb at risk.Aim: To investigate the level of awareness of lymphedema prevention and the frequency of the post-mastectomy patients’ compliance with the received recommendations.Material and methods: 40 women after one-side radical mastectomy and post-surgical radiotherapy took part in the research. None of them had symptoms of recurrence. All patients had a clinical manifestation of upper limb lymphedema at the side of the surgical intervention. The patients were asked to fill in a questionnaire that consisted of 6 questions.Results: The research has shown that patients with risk of lymphedema display a low level of education in the matter and that they indicate problems with access to professional information on the topic of lymphedema prevention. The properly trained medical staff rarely proved to be a source of information on the topic. The women who participated in the survey mostly knew that they had to avoid injections and taking blood pressure in the affected upper limb as well as excessive upper limb exercise. Most frequently mentioned preventive recommendations included elevation of the limb and appropriate exercise. Among the factors generating lymphedema, most women indicated excessive physical effort as a subjective cause of the manifestation of the condition.Conclusion: Despite the knowledge of lymphedema prevention measures, the patients often fail to comply with the recommendations they have been given.
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Lymphedema of upper limb after radical treatment of breast cancer patients: current management principles

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Kołodziejski L. S., Łobaziewicz W., Ochałek K., Niedbała E.
Medical Rehabilitation
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2009
|
vol. 13(2)
23-31
EN
Upper limb lymphedema (ULL) is the most severe late complication following radical treatment of breast cancer (BC). It can be caused by both cancer recurrence and previous therapy (lymphadenectomy, axillary radiotherapy). In BC survivors, ULL- inducing factors include: previous irradiation treatment, infections within the upper limb or the scar, high BMI. Diagnosis of ULL makes use of measurements of the circumference and volume of the limb, imaging, measuring electrical impedance of tissues and lymphoscintigraphy which determines the type and severity of lymph flow disturbances. ULL has a chronic and progressive nature leading to physical, psychic and social disability and, on rare occasions, to secondary neoplasms of the lymphatic system. Therapeutic management involves: patients’ education, complex physical therapy (manual lymphatic drainage, compression therapy), reduction and drainage surgery (microsurgery) as well as liposuction. The most effective conservative procedures include complex physical therapy and particularly manual lymphatic drainage with compression therapy. Failure of conservative therapy indicates the need for surgery. Liposuction is a currently preferred surgical procedure because of its simplicity and a low percentage of complications. Surgery should be complemented by constant compression therapy. Due to low efficiency of all the methods applied, ULL prevention is of paramount importance. It should consist in rationalising indications for oncological treatment (lymphadenectomy, radiation therapy).
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