Role of physiotherapy and patient education in lymphedema control following breast cancer surgery

被引:31
作者
Lu, Shiang-Ru [1 ]
Hong, Rong-Bin [2 ,3 ]
Chou, Willy [4 ]
Hsiao, Pei-Chi [4 ,5 ]
机构
[1] Kaohsiung Med Univ Hosp, Dept Neurol, Kaohsiung, Taiwan
[2] Chi Mei Med Ctr, Dept Phys Med, Tainan 71004, Taiwan
[3] Chi Mei Med Ctr, Dept Rehabil, Tainan 71004, Taiwan
[4] Chi Mei Med Ctr, Dept Phys Med & Rehabil, Tainan 71004, Taiwan
[5] Chia Nan Univ Pharm & Sci, Dept Recreat & Hlth Care Management, Tainan, Taiwan
来源
THERAPEUTICS AND CLINICAL RISK MANAGEMENT | 2015年 / 11卷
关键词
breast cancer; lymphedema; physical therapy; education; LYMPHATIC REGENERATION; NODE DISSECTION; ARM LYMPHEDEMA; SURVIVORS; RISK; METAANALYSIS; EXERCISE; ADVICE; WOMEN; CARE;
D O I
10.2147/TCRM.S77669
中图分类号
R19 [保健组织与事业(卫生事业管理)];
学科分类号
摘要
Introduction: This retrospective cohort study evaluated whether education in combination with physiotherapy can reduce the risk of breast cancer-related lymphedema (BCRL). Methods: We analyzed 1,217 women diagnosed with unilateral breast cancer between January 2007 and December 2011 who underwent tumor resection and axillary lymph node dissection. The patients were divided into three groups: Group A (n=415), who received neither education nor physiotherapy postsurgery; Group B (n=672), who received an educational program on BCRL between Days 0 and 7 postsurgery; and Group C (n=130), who received an educational program on BCRL between Days 0 and 7 postsurgery, followed by a physiotherapy program. All patients were monitored until October 2013 to determine whether BCRL developed. BCRL risk factors were evaluated using Cox proportional hazards models. Results: During the follow-up, 188 patients (15.4%) developed lymphedema, including 77 (18.6%) in Group A, 101 (15.0%) in Group B, and 10 (7.7%) in Group C (P=0.010). The median period from surgery to lymphedema was 0.54 years (interquartile range =0.18-1.78). The independent risk factors for BCRL included positive axillary lymph node invasion, a higher (>20) number of dissected axillary lymph nodes, and having undergone radiation therapy, whereas receiving an educational program followed by physiotherapy was a protective factor against BCRL (hazard ratio =0.35, 95% confidence interval =0.18-0.67, P=0.002). Conclusion: Patient education that begins within the first week postsurgery and is followed by physiotherapy is effective in reducing the risk of BCRL in women with breast cancer.
引用
收藏
页码:319 / 327
页数:9
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