Psychological consequences of lymphoedema associated with breast cancer: a prospective cohort study

BACKGROUND: The aim of this prospective cohort study of women attending a rehabilitation course at the Dallund Rehabilitation Centre was to explore the emotional and psychological aspects of living with lymphoedema, expressed as psychological distress, poorer quality of life and poorer self-reported health.

METHODS: Between November 2002 and January 2007 within the FOCARE study, self-completed questionnaires were collected 3 weeks before and 6 and 12 months after the rehabilitation course to elicit sociodemographic, physical and lifestyle information and responses to three psychometric tests. The population consisted of 633 women, 125 with and 508 without verified lymphoedema (time since surgery, 1 month-5 years). The population was reduced to 553 women at the first follow-up and 494 at the second.

RESULTS: Multivariate analysis showed that, in comparison with women without lymphoedema, those with lymphoedema had a 14% higher risk for scoring one level higher on the POMS-SF test, a 9% higher probability of scoring one point lower on the quality of life scale and a 29% higher likelihood of reporting poorer or bad health than women without lymphoedema. These findings were seen at all three measurement times.

CONCLUSIONS: In this cohort of women with breast cancer, women with lymphoedema after surgery for breast cancer had significantly worse overall emotional well-being and adjustment to life compared to women without lymphoedema.