Disparities in Breast Cancer–related Lymphedema: A Systematic Review of Inequities and Barriers in Care
Background:. Breast cancer–related lymphedema (BCRL) is a chronic condition secondary to multimodal cancer treatment. This systematic review summarized the evidence for disparities and barriers surrounding BCRL care, particularly in diagnosis, education, and accessibility to treatment. Methods:. A s...
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| Format: | Article |
| Language: | English |
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Wolters Kluwer
2025-07-01
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| Series: | Plastic and Reconstructive Surgery, Global Open |
| Online Access: | http://journals.lww.com/prsgo/fulltext/10.1097/GOX.0000000000006935 |
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| author | Alexzandra Mattia, BS Nina Hadzimustafic, MD Rachel Rivero, MD SeungJu Jackie Oh, MD Karen Bach, MD Stav Brown, MD Siba Haykal, MD, PhD |
| author_facet | Alexzandra Mattia, BS Nina Hadzimustafic, MD Rachel Rivero, MD SeungJu Jackie Oh, MD Karen Bach, MD Stav Brown, MD Siba Haykal, MD, PhD |
| author_sort | Alexzandra Mattia, BS |
| collection | DOAJ |
| description | Background:. Breast cancer–related lymphedema (BCRL) is a chronic condition secondary to multimodal cancer treatment. This systematic review summarized the evidence for disparities and barriers surrounding BCRL care, particularly in diagnosis, education, and accessibility to treatment.
Methods:. A search of PubMed/MEDLINE, Embase, Scopus, and Web of Science following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines was conducted from January 1, 1990, through October 3, 2024. Mixed-methods, qualitative, cross-sectional, multiple-case, longitudinal, and randomized controlled trials that reported disparities and barriers surrounding BCRL care were included. Review articles, editorials, commentaries, abstracts, poster papers, translation or validation of patient-reported outcome measures, and non-English articles were excluded.
Results:. The search yielded 1059 articles, and 39 met inclusion criteria. Themes identified included the following: racial and ethnic disparities; increased risk associated with younger age, low education level, low income, rural geographic location, and presence of medical comorbidities; inadequate provider and patient knowledge; low patient education; burden and challenges with lifelong self-management; and barriers in receiving healthcare provider diagnosis or adequate BCRL management. Subthemes included cumulative cost burden, psychosocial barriers, and the role of patient self-efficacy.
Conclusions:. Younger non-White women, residents of rural regions, and those with low income or education levels seemed to be at greatest risk for self-reported (rather than physician-diagnosed) BCRL. Patients of diverse racial and ethnic backgrounds and low socioeconomic status were at increased risk for inadequate self-care education and breast cancer survivorship support. Active prevention with multidisciplinary interventions is imperative to lower BCRL rates, empower breast cancer survivors, and strengthen self-efficacy. |
| format | Article |
| id | doaj-art-324e57fa911c48b08baf5d5df89449d5 |
| institution | Kabale University |
| issn | 2169-7574 |
| language | English |
| publishDate | 2025-07-01 |
| publisher | Wolters Kluwer |
| record_format | Article |
| series | Plastic and Reconstructive Surgery, Global Open |
| spelling | doaj-art-324e57fa911c48b08baf5d5df89449d52025-08-20T03:55:49ZengWolters KluwerPlastic and Reconstructive Surgery, Global Open2169-75742025-07-01137e693510.1097/GOX.0000000000006935202507000-00007Disparities in Breast Cancer–related Lymphedema: A Systematic Review of Inequities and Barriers in CareAlexzandra Mattia, BS0Nina Hadzimustafic, MD1Rachel Rivero, MD2SeungJu Jackie Oh, MD3Karen Bach, MD4Stav Brown, MD5Siba Haykal, MD, PhD6From the * Division of Plastic and Reconstructive Surgery, Department of Surgery, Yale School of Medicine, New Haven, CT† Division of Plastic, Reconstructive, and Aesthetic Surgery, Department of Surgery, McGill University, Montreal, Quebec, Canada‡ Department of Surgery, Yale New Haven Hospital, New Haven, CT.From the * Division of Plastic and Reconstructive Surgery, Department of Surgery, Yale School of Medicine, New Haven, CTFrom the * Division of Plastic and Reconstructive Surgery, Department of Surgery, Yale School of Medicine, New Haven, CTFrom the * Division of Plastic and Reconstructive Surgery, Department of Surgery, Yale School of Medicine, New Haven, CTFrom the * Division of Plastic and Reconstructive Surgery, Department of Surgery, Yale School of Medicine, New Haven, CTBackground:. Breast cancer–related lymphedema (BCRL) is a chronic condition secondary to multimodal cancer treatment. This systematic review summarized the evidence for disparities and barriers surrounding BCRL care, particularly in diagnosis, education, and accessibility to treatment. Methods:. A search of PubMed/MEDLINE, Embase, Scopus, and Web of Science following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines was conducted from January 1, 1990, through October 3, 2024. Mixed-methods, qualitative, cross-sectional, multiple-case, longitudinal, and randomized controlled trials that reported disparities and barriers surrounding BCRL care were included. Review articles, editorials, commentaries, abstracts, poster papers, translation or validation of patient-reported outcome measures, and non-English articles were excluded. Results:. The search yielded 1059 articles, and 39 met inclusion criteria. Themes identified included the following: racial and ethnic disparities; increased risk associated with younger age, low education level, low income, rural geographic location, and presence of medical comorbidities; inadequate provider and patient knowledge; low patient education; burden and challenges with lifelong self-management; and barriers in receiving healthcare provider diagnosis or adequate BCRL management. Subthemes included cumulative cost burden, psychosocial barriers, and the role of patient self-efficacy. Conclusions:. Younger non-White women, residents of rural regions, and those with low income or education levels seemed to be at greatest risk for self-reported (rather than physician-diagnosed) BCRL. Patients of diverse racial and ethnic backgrounds and low socioeconomic status were at increased risk for inadequate self-care education and breast cancer survivorship support. Active prevention with multidisciplinary interventions is imperative to lower BCRL rates, empower breast cancer survivors, and strengthen self-efficacy.http://journals.lww.com/prsgo/fulltext/10.1097/GOX.0000000000006935 |
| spellingShingle | Alexzandra Mattia, BS Nina Hadzimustafic, MD Rachel Rivero, MD SeungJu Jackie Oh, MD Karen Bach, MD Stav Brown, MD Siba Haykal, MD, PhD Disparities in Breast Cancer–related Lymphedema: A Systematic Review of Inequities and Barriers in Care Plastic and Reconstructive Surgery, Global Open |
| title | Disparities in Breast Cancer–related Lymphedema: A Systematic Review of Inequities and Barriers in Care |
| title_full | Disparities in Breast Cancer–related Lymphedema: A Systematic Review of Inequities and Barriers in Care |
| title_fullStr | Disparities in Breast Cancer–related Lymphedema: A Systematic Review of Inequities and Barriers in Care |
| title_full_unstemmed | Disparities in Breast Cancer–related Lymphedema: A Systematic Review of Inequities and Barriers in Care |
| title_short | Disparities in Breast Cancer–related Lymphedema: A Systematic Review of Inequities and Barriers in Care |
| title_sort | disparities in breast cancer related lymphedema a systematic review of inequities and barriers in care |
| url | http://journals.lww.com/prsgo/fulltext/10.1097/GOX.0000000000006935 |
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