Breast Cancer Survivors' Intentions of Managing Lymphedema

Mei R. Fu, PhD, RN, CNS


Cancer Nurs. 2005;28(6):446-457. 

In This Article

Abstract and Introduction

The purpose of this study was to describe the experience of managing lymphedema in breast cancer survivors. A descriptive phenomenological method was used as a guide for developing a bracket, gathering data, and analyzing data. A cross-sectional design with a purposive sampling technique was employed. During the 3 private, semi-structured, audio-recorded interviews with each woman, 12 breast cancer survivors described how they managed lymphedema in their daily lives. A taxonomy of 3 levels was created to describe the essential structures of the experience from general, to mediating, to specific: revelatory intention, cluster intention, and unit intention. The study revealed that the women's major intentions of managing lymphedema were to keep in mind the consequences, prevent lymphedema from getting worse, get ready to live with lymphedema, and integrate the care of lymphedema into daily life. Findings of the study provided an insightful alternative to the compliance approach to lymphedema management. Instead of merely evaluating breast cancer survivors' degree of compliance with treatment, it is suggested that researchers and practitioners should also assess the impact of the presence or absence of the women's intentions on lymphedema management.

Lymphedema is a serious long-term complication from breast cancer surgery and radiation therapy.[1,2] Approximately 20% to 40% of the 2 million breast cancer survivors in the United States have developed lymphedema, all women following breast cancer treatment are at risk for lymphedema in their lifetime.[3,4,5] Traditionally, axillary lymph nodes dissection, following mastectomy or lumpectomy, has been the major cause of lymphedema.[5,6] Advances in surgical approach such as sentinel lymph node biopsy and breast conservation surgery have showed some promising results in decreasing lymphedema occurrence. However, such surgical approaches may not fully protect women from lymphedema because approximately 20% of the women who underwent sentinel lymph node biopsy have also experienced lymphedema.[7]

Lymphedema following breast cancer treatment is a chronic condition in which interruptions or obstructions of lymphatic vessels lead to the accumulation of lymph fluid in the interstitial spaces, resulting in persistent swelling in the affected areas, such as arm, hand, wrist, neck, shoulder, or thoracic regions.[8,9] The swelling often causes a wide range of discomfort and disability. The impact of lymphedema on breast cancer survivors includes physical, functional, occupational, psychosocial, cognitive, lifestyle, and financial dimensions.[10,11,12,13] Similar to other chronic illnesses, lymphedema cannot be cured and all the treatment requires breast cancer survivors to change their lifestyle and maintain daily and lifelong care to decrease the swelling and prevent exacerbations.[14] Adherence to daily care has been identified as the most important factor that impacts lymphedema management.[15] The purpose of the study was to describe breast cancer survivors' experience of managing lymphedema in their daily lives.


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