Frequency of self-reported symptoms in patients with and without breast cancer-related lymphoedema and their associations with the outcomes of objective lymphoedema assessments
Aysel Özge Kemer, Esra Üzelpasacı, Türkan Akbayrak, Serap Özgül, Ayşegül Yaman, Ceren GürşenObjectives
Breast cancer is a major health burden, and breast cancer-related lymphoedema (BCRL) is a potentially persistent complication that may cause swelling, heaviness, tightness, pain and functional and psychological limitations. This study compared the frequency of self-reported symptoms between patients with and without BCRL and examined associations between symptom severity and distress and objective lymphoedema measures.
Methods
A total of 120 women who completed primary cancer treatment were included (n=68 with BCRL; n=52 without BCRL). Symptom severity and distress were assessed using the Visual Analogue Scale. Arm volume, the Lymphoedema Index (L-Dex) derived from bioimpedance spectroscopy and local tissue water (LTW) assessed by tissue dielectric constant were measured. Group differences were analysed using the χ 2 test, and associations using Spearman’s correlation. Statistical significance was set at p<0.05.
Results
Swelling (86.8% vs 44.2%, χ²=24.60, p<0.001), heaviness (89.7% vs 46.2%, χ²=27.00, p<0.001), tightness (79.4% vs 53.8%, χ²=8.90, p=0.003) and pain (79.4% vs 57.7%, χ²=6.61, p=0.010) were significantly more frequent in the BCRL than non-BCRL group. Weak-to-moderate significant correlations were observed between symptom severity and distress related to swelling, heaviness, and tightness and arm volume difference (r=0.34–0.52, p<0.001) and L-Dex scores (r=0.33–0.46, p<0.001), and arm and forearm LTW ratios (r=0.26–0.37, p=0.006 to <0.001).
Conclusions
Self-reported symptoms were more prevalent in patients with BCRL. Despite significant but weak-to-moderate associations with objective measures, these findings highlight that symptom reporting provides valuable complementary information and should be interpreted alongside objective assessments in the evaluation of BCRL.