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Multicenter Study
. 2016 Jul;32(6):484-90.
doi: 10.1055/s-0036-1572538. Epub 2016 Feb 26.

Quality of Life in Patients with Breast Cancer-Related Lymphedema and Reconstructive Breast Surgery

Tiara R Lopez Penha  1 , Bente Botter  1 , Esther M Heuts  2 , Adri C Voogd  3 , Maarten F von Meyenfeldt  2 , René R van der Hulst  1
Affiliations
Multicenter Study

Quality of Life in Patients with Breast Cancer-Related Lymphedema and Reconstructive Breast Surgery

Tiara R Lopez Penha et al. J Reconstr Microsurg. 2016 Jul.

Abstract

Background To evaluate the quality of life (QOL) of breast cancer survivors who have undergone breast reconstruction and have breast cancer-related lymphedema (BCRL). Methods Patients with a unilateral mastectomy with or without breast reconstruction were evaluated for BCRL and their QOL. Patients were divided into a non-BCRL and a BCRL group. Patients with subjective complaints of arm swelling and/or an interlimb volume difference of >200 mL, or undergoing treatment for arm lymphedema were defined as having BCRL. QOL was assessed using cancer-specific (EORTC QLQ-C30 and EORTC QLQ-B23) and disease specific (Lymph-ICF) questionnaires. Results In total, 253 patients with a mean follow-up time of 51.7 (standard deviation = 18.5) months since mastectomy completed the QOL questionnaires. Of these patients, 116 (46%) underwent mastectomy alone and 137 (54%) had additional breast reconstruction. A comparison of the QOL scores of 180 patients in the non-BCRL group showed a significantly better physical function (p = 0.004) for patients with reconstructive surgery compared with mastectomy patients. In the 73 patients with BCRL, a comparison of the QOL scores showed no significant differences between patients with mastectomy and reconstructive surgery. After adjusting for potential confounders, multivariate analysis showed a significant impact of BCRL on physical function (β = - 7.46; p = 0.009), role function (β = - 15.75; p = 0.003), cognitive function (β = - 11.56; p = 0.005), body vision (β = - 11.62; p = 0.007), arm symptoms (β = 20.78; p = 0.000), and all domains of the Lymph-ICF questionnaire. Conclusions This study implies that BCRL has a negative effect on the QOL of breast cancer survivors, potentially negating the positive effects on QOL reconstructive breast surgery has.

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