Lymphoedema and Breast Cancer. A Physiotherapeutic Approach.

Research output: ThesisDoctoral Thesis (compilation)

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Abstract

Ten percent of the female population in Sweden will be diagnosed with breast cancer during their lifetime, but only a minority will die from the disease. Arm lymph oedema is a well-known complication following breast cancer treatment and the incidence varies between about 10% when axillary node dissection is performed and about 40% when axillary radiotherapy is added.

The general aim of this thesis was to identify risk factors and onset, evaluate treatments and explore, from a physiotherapeutic perspective, the experiences of patients with arm lymphoedema following breast cancer treatment.

Results revealed that patients treated with additional axillary radiotherapy were associated with early development of arm lymphoedema and reduced shoulder mobility that remained during a 2-year follow-up period. Shoulder muscle strength was reduced to all patients treated with axillary node dissection independent of radiotherapy treatment. Women treated for breast cancer with axillary node dissection, with or without adjuvant radiotherapy, can be recommended to maintain their level of occupational workload and physical activity without an added risk of developing arm lymphoedema. However, it is reasonable to assume that a higher body mass index increases the risk.

Two intervention studies showed that compression with low-stretch bandaging was the most effective short-time lymphoedema reducing treatment. Manual lymph drainage, a massage technique, also reduced the lymphoedema considerably. Manual lymph drainage, combined with compression bandaging, was more effective than compression bandaging alone. Sequential pneumatic compression also had a lymphoedema reducing effect and in comparison with manual lymph drainage, no difference between the treatments was found.

In a qualitative interview study, women with slight or moderate arm lymphoedema expressed their experiences, revealing problems with attitudes from people in the surroundings and problems with the chronic disease. The problems integrated in daily life were of low frequency but of considerable importance to the women. The women used both problem-focused and emotion-focused coping strategies. Thus, it is of importance that health care professionals are aware of and have knowledge about these problems. It is reasonable to believe, that he women's need to express their experiences, should be encouraged and efforts made to strengthen the women's coping skills.
Original languageEnglish
QualificationDoctor
Awarding Institution
  • Human Movement: health and rehabilitation
Supervisors/Advisors
  • [unknown], [unknown], Supervisor, External person
Award date2002 Mar 1
Publisher
ISBN (Print)91-628-5117-9
Publication statusPublished - 2002

Bibliographical note

Defence details

Date: 2002-03-01
Time: 10:15
Place: University Hospital, Lund

External reviewer(s)

Name: Emdin, Stefan
Title: Associate Professor,
Affiliation: Norrland University Hospital, Umeå

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Article: I. Johansson K, Ingvar C, Albertsson M, Ekdahl C. Arm lymphoedema, shoulder mobilityand muscle strength after breast cancer treatment. A prospective 2-year study.Advances in Physiotherapy 2001; 3: 55-66.

Article: II. Johansson K, Ohlsson K, Albertsson M, Ingvar C, Ekdahl C. Factors associated with thedevelopment of arm lymphedema following breast cancer treatment: A match pair case- control study. Lymphology (Accepted 2001)

Article: III. Johansson K, Lie E, Ekdahl C, Lindfeldt J. A randomized study comparing manual lymph drainage with sequential pneumatic compression for treatment of postoperative arm lymphedema. Lymphology 1998; 31: 56-64.IV: Johansson K, Albertsson M, Ingvar C, Ekdahl C. Effects of compression bandaging with or without manual lymph drainage treatment in patients with postoperative arm lymphedema. Lymphology 1999; 32: 103-110.

Article: V. Johansson K, Holmström H, Nilsson I, Albertsson M, Ingvar C, Ekdahl C. Breast cancer patients' experiences of lymphedema. (Submitted).

The information about affiliations in this record was updated in December 2015.
The record was previously connected to the following departments: Division of Physiotherapy (Closed 2012) (013042000)

Subject classification (UKÄ)

  • Physiotherapy

Free keywords

  • cancer
  • onkologi
  • Cytologi
  • coping.
  • Cytology
  • oncology
  • cancerology
  • chronic disease
  • qualitative study
  • pneumatic compression
  • manual lymph drainage
  • compression therapy
  • BMI
  • workload
  • shoulder strength
  • shoulder mobility
  • Breast cancer
  • lymphoedema

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