Wednesday, August 29, 2012

Patient awareness and knowledge of breast cancer-related lymphedema in a large, integrated health care delivery system.

Patient awareness and knowledge of breast cancer-related lymphedema in a large, integrated health care delivery system.

Sept 2012

Marilyn L. KwanLing ShenJulie R. MunnekeEmily K. TamPaula N. ParteeMary André,Susan E. KutnerCarol P. SomkinLynn M. Ackerson and Saskia R. J. Thiadens


Division of Research, Kaiser Permanente Northern California, 2000 Broadway, Oakland, CA, 94612, USA,


Breast cancer patients have voiced dissatisfaction regarding their education on breast cancer-related lymphedema risk and risk reduction strategies from their clinicians. Informing patients about lymphedema can contribute to decrease their risk of developing the condition, or among those already affected, prevent it from progressing further. In this cross-sectional study, a lymphedema awareness score was calculated based on responses to a brief telephone interview conducted among 389 women diagnosed with invasive breast cancer at Kaiser Permanente Northern California from 2000 to 2008 and had a previous record of a lymphedema-related diagnosis or procedure in their electronic medical record. 

During the telephone interview, women self-reported a lymphedema clinical diagnosis, lymphedema symptoms but nolymphedema diagnosis, or neither a diagnosis nor symptoms, and responded to questions on lymphedema education and support services as well as health knowledge. Multivariable logistic regression [odds ratio (OR) and 95 % confidence interval (CI)] was used to determine the associations of selected sociodemographic and clinical factors with the odds of having lymphedema awareness (adequate vs. inadequate). 

These results can help inform educational interventions to strengthen patient knowledge of lymphedema risk and risk reduction practices, particularly in an integrated health care delivery setting. With the growing population of breast cancer survivors, increasing patient awareness and education about lymphedema risk reduction and care after cancer diagnosis is warranted.

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