UICC World Cancer Congress 2006

The lymphedema risk reduction education and symptom management project was developed to eliminate a fragmented approach for patients with breast cancer. Lymphedema remains a significant risk and a difficult management and quality of life issue for patients. Literature review revealed that lymphedema occurrence ranges from 6 – 70% with an average of 23.6%. More than 50-60% of patients do not receive appropriate education about risk or precautions. Frequently, a patient's subsequent treatment can be affected if lymphedema results in restricted arm movement during radiation therapy, increased infection risk and limited IV access for chemotherapy administration. Typically, intervention occurs once lymphedema has developed rather than focusing concerted efforts on prevention. Education of health care professionals is imperative to successful management of these patients.

Methods:

Standardization of pre and post-surgical education (including illustrated exercises), and standardized post-op orders, with automatic referrals to occupational therapy were implemented and are expected to improve the quality of life for patients at risk. Occupational therapy addresses progression of exercises if indicated, functional limitations if present and education to minimize risk factors for developing lymphedema, including self-monitoring of upper-extremity girth.

Results:

Patients are evaluated frequently in the immediate postoperative period then every 6 months until two years postoperative. Assessments and measurements are conducted to determine if lymphedema is developing. It is expected that with risk reduction education, a standardized exercise protocol, and ongoing patient monitoring, early intervention can be implemented resulting in improved quality of life.