RESUMEN
BACKGROUND: The aim of this study was to describe availability of treatment for lymphoedema in Australia to enable physicians to manage patients with lymphoedema. METHODS: A validated questionnaire was sent to the Review and Survey Group of the Breast Cancer Network of Australia in May 2010 (n = 760) to investigate consumers' perspectives on treatment access. RESULTS: Responses were received from 444 women (58%) of whom 140 had received lymphoedema treatment in the previous 5 years. Barriers were encountered by 33% (n = 46). These barriers included access to a lymphoedema therapist (n = 34), treatment affordability (n = 27), need to travel to access treatment (n = 21) and not knowing where to find help (n = 20). DISCUSSION: One-third of this group of women had difficulty accessing treatment to halt this potentially progressive condition. The general practitioner has an important role in detecting this condition, and advising where treatment can be accessed and which schemes might assist financially.
Asunto(s)
Neoplasias de la Mama/complicaciones , Accesibilidad a los Servicios de Salud/estadística & datos numéricos , Linfedema/terapia , Australia , Femenino , Medicina General , Encuestas de Atención de la Salud , Accesibilidad a los Servicios de Salud/economía , Humanos , Linfedema/economía , Linfedema/etiología , Encuestas y CuestionariosRESUMEN
Limited high-quality research has focused on the efficacy of lymphedema treatments and symptomatic relief. With that in mind, the authors conducted a cross-sectional survey to describe the presentation of breast cancer-related lymphedema, treatment modalities used, and perceived effectiveness. An electronic validated questionnaire to assess the presentation of lymphedema, severity of swelling and discomfort, number of modalities tried, and the benefits gained from treatment was completed by the Review and Survey Group of the Breast Cancer Network of Australia. Thirty-five percent of participants reported the presence of lymphedema, a majority of which reported it to be mild or moderate for magnitude of swelling and for discomfort. The correlation was weak between magnitude of swelling and discomfort. Compression, massage, and exercise were the most commonly used modalities in these patients. Notably, chest wall or breast lymphedema--about which research is lacking--was as common as hand lymphedema. Women experienced discomfort and physical changes, although the severity of the two was not related. Some benefit was reported for all modalities, but no particular modality was considered extremely helpful. Oncology nurses are ideally positioned to monitor women for early signs of swelling and to advise women on the range of treatments available.
Asunto(s)
Neoplasias de la Mama/complicaciones , Linfedema/etiología , Adulto , Anciano , Neoplasias de la Mama/psicología , Recolección de Datos , Humanos , Internet , Linfedema/fisiopatología , Linfedema/terapia , Persona de Mediana Edad , Índice de Severidad de la Enfermedad , Encuestas y CuestionariosRESUMEN
BACKGROUND: Vaccinations have been linked to lymphoedema but there is no quality scientific evidence to support or refute a causative relationship. OBJECTIVE: We report on a case of a breast cancer patient who developed lymphoedema following vaccination in her 'at risk' arm. She had previously undergone mastectomy and axillary clearance but did not have lymphoedema before the vaccinations. DISCUSSION: The risk of lymphoedema is still present for many years following breast surgery. Patients who are at risk of lymphoedema should be warned to report persistent swelling after vaccination so that they can be referred early for physiotherapy intervention if required.