Assessing the Impact of Lymphedema Therapy Referral on Breast Cancer Survivors’ Lymphedema Knowledge: A Cross-Sectional Survey

Abstract Background Lymphedema is a common problem that adversely impacts quality of life in breast cancer survivors. Although lymphedema risk is modifiable through behavior change, there is no standardized approach to educate survivors about risk-lowering strategies. Furthermore, misconceptions abo...

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Main Authors: Madelyn Klugman, Yashasvini Sampathkumar, Sujata Patil, Kathryn R. Tringale, Giacomo Montagna, Jackie Finik, Ting-Ting Kuo, Carolyn Eberle, Alexandr Pinkhasov, Theresa Gillis, Francesca Gany, Victoria Blinder
Format: Article
Language:English
Published: BMC 2025-03-01
Series:BMC Women's Health
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Online Access:https://doi.org/10.1186/s12905-025-03654-x
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author Madelyn Klugman
Yashasvini Sampathkumar
Sujata Patil
Kathryn R. Tringale
Giacomo Montagna
Jackie Finik
Ting-Ting Kuo
Carolyn Eberle
Alexandr Pinkhasov
Theresa Gillis
Francesca Gany
Victoria Blinder
author_facet Madelyn Klugman
Yashasvini Sampathkumar
Sujata Patil
Kathryn R. Tringale
Giacomo Montagna
Jackie Finik
Ting-Ting Kuo
Carolyn Eberle
Alexandr Pinkhasov
Theresa Gillis
Francesca Gany
Victoria Blinder
author_sort Madelyn Klugman
collection DOAJ
description Abstract Background Lymphedema is a common problem that adversely impacts quality of life in breast cancer survivors. Although lymphedema risk is modifiable through behavior change, there is no standardized approach to educate survivors about risk-lowering strategies. Furthermore, misconceptions about lymphedema risk factors and risk-lowering strategies are common. The aim of this study was to evaluate the effect of lymphedema therapy referral on knowledge about lymphedema risk. Methods This was a cross-sectional single institution study in which breast cancer survivors at a National Cancer Institute-designated cancer center completed an anonymous questionnaire between 2014 and 2015. Eligibility criteria were age ≥ 18, female sex, English-speaking, > 6 months post definitive breast cancer surgery, no cancer recurrence, and no prior or subsequent second cancer. The questionnaire included sociodemographic variables, clinical factors including prior lymphedema therapy referral, and 10 true/false questions assessing knowledge about lymphedema risk. Multivariable logistic regression analyses assessed the relationship between prior lymphedema therapy referral and correctly answering questions about lymphedema risk. Results Of 209 participants, 53 (25%) had been referred to lymphedema therapy. Those who had undergone sentinel lymph node biopsy were less frequently referred to lymphedema therapy [15 (14%)] than those who had undergone axillary lymph node dissection [38 (39%)]. Five of the true/false questions had a correct response rate of < 80%. After controlling for age, race/ethnicity, education, type of axillary surgery, and receipt of radiation therapy, referral for lymphedema therapy was associated with correctly answering two questions about lymphedema: weight gain increases lymphedema risk [odds ratio, 95% confidence interval: 3.63 (1.66–7.96)] and patients are recommended to exercise their arm on an airplane [2.65 (1.15–6.13)]. Conclusions Misconceptions about lymphedema prevention and management are common among breast cancer survivors. Lymphedema therapy referral is a potential opportunity to debunk misunderstandings and educate at-risk patients regarding lymphedema.
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spelling doaj-art-9dc38dd542c849ef8bacda2b5a3d21732025-08-20T02:56:21ZengBMCBMC Women's Health1472-68742025-03-012511910.1186/s12905-025-03654-xAssessing the Impact of Lymphedema Therapy Referral on Breast Cancer Survivors’ Lymphedema Knowledge: A Cross-Sectional SurveyMadelyn Klugman0Yashasvini Sampathkumar1Sujata Patil2Kathryn R. Tringale3Giacomo Montagna4Jackie Finik5Ting-Ting Kuo6Carolyn Eberle7Alexandr Pinkhasov8Theresa Gillis9Francesca Gany10Victoria Blinder11The Sidney Kimmel Comprehensive Cancer Center at Johns HopkinsDepartment of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer CenterQuantitative Health Sciences Department, Cleveland ClinicDepartment of Radiation Medicine and Applied Sciences, University of California, San Diego School of MedicineBreast Service, Department of Surgery, Memorial Sloan Kettering Cancer CenterImmigrant Health and Cancer Disparities Service, Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer CenterRehabilitation Medicine Service, Department of Neurology, Memorial Sloan Kettering Cancer CenterDepartment of Epidemiology, UNC Gillings School of Public HealthDepartment of Urology, SUNY Upstate University HospitalRehabilitation Medicine Service, Department of Neurology, Memorial Sloan Kettering Cancer CenterImmigrant Health and Cancer Disparities Service, Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer CenterImmigrant Health and Cancer Disparities Service, Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer CenterAbstract Background Lymphedema is a common problem that adversely impacts quality of life in breast cancer survivors. Although lymphedema risk is modifiable through behavior change, there is no standardized approach to educate survivors about risk-lowering strategies. Furthermore, misconceptions about lymphedema risk factors and risk-lowering strategies are common. The aim of this study was to evaluate the effect of lymphedema therapy referral on knowledge about lymphedema risk. Methods This was a cross-sectional single institution study in which breast cancer survivors at a National Cancer Institute-designated cancer center completed an anonymous questionnaire between 2014 and 2015. Eligibility criteria were age ≥ 18, female sex, English-speaking, > 6 months post definitive breast cancer surgery, no cancer recurrence, and no prior or subsequent second cancer. The questionnaire included sociodemographic variables, clinical factors including prior lymphedema therapy referral, and 10 true/false questions assessing knowledge about lymphedema risk. Multivariable logistic regression analyses assessed the relationship between prior lymphedema therapy referral and correctly answering questions about lymphedema risk. Results Of 209 participants, 53 (25%) had been referred to lymphedema therapy. Those who had undergone sentinel lymph node biopsy were less frequently referred to lymphedema therapy [15 (14%)] than those who had undergone axillary lymph node dissection [38 (39%)]. Five of the true/false questions had a correct response rate of < 80%. After controlling for age, race/ethnicity, education, type of axillary surgery, and receipt of radiation therapy, referral for lymphedema therapy was associated with correctly answering two questions about lymphedema: weight gain increases lymphedema risk [odds ratio, 95% confidence interval: 3.63 (1.66–7.96)] and patients are recommended to exercise their arm on an airplane [2.65 (1.15–6.13)]. Conclusions Misconceptions about lymphedema prevention and management are common among breast cancer survivors. Lymphedema therapy referral is a potential opportunity to debunk misunderstandings and educate at-risk patients regarding lymphedema.https://doi.org/10.1186/s12905-025-03654-xDisabilityPhysical therapySurvivorshipSymptom management
spellingShingle Madelyn Klugman
Yashasvini Sampathkumar
Sujata Patil
Kathryn R. Tringale
Giacomo Montagna
Jackie Finik
Ting-Ting Kuo
Carolyn Eberle
Alexandr Pinkhasov
Theresa Gillis
Francesca Gany
Victoria Blinder
Assessing the Impact of Lymphedema Therapy Referral on Breast Cancer Survivors’ Lymphedema Knowledge: A Cross-Sectional Survey
BMC Women's Health
Disability
Physical therapy
Survivorship
Symptom management
title Assessing the Impact of Lymphedema Therapy Referral on Breast Cancer Survivors’ Lymphedema Knowledge: A Cross-Sectional Survey
title_full Assessing the Impact of Lymphedema Therapy Referral on Breast Cancer Survivors’ Lymphedema Knowledge: A Cross-Sectional Survey
title_fullStr Assessing the Impact of Lymphedema Therapy Referral on Breast Cancer Survivors’ Lymphedema Knowledge: A Cross-Sectional Survey
title_full_unstemmed Assessing the Impact of Lymphedema Therapy Referral on Breast Cancer Survivors’ Lymphedema Knowledge: A Cross-Sectional Survey
title_short Assessing the Impact of Lymphedema Therapy Referral on Breast Cancer Survivors’ Lymphedema Knowledge: A Cross-Sectional Survey
title_sort assessing the impact of lymphedema therapy referral on breast cancer survivors lymphedema knowledge a cross sectional survey
topic Disability
Physical therapy
Survivorship
Symptom management
url https://doi.org/10.1186/s12905-025-03654-x
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