UC San Diego

Background : While the incidence of breast cancer-related lymphedema has decreased with advancements in breast cancer treatments, it is still a common late effect of treatment and more research is needed to better understand its physical and psychosocial impact among breast cancer survivors. The Women's Healthy Eating and Living (WHEL) Study (a randomized trial to test the effect of a plant- based diet among breast cancer survivors) provided a dataset for this research. Additionally, medical charts from breast cancer patients at a large academic medical center were reviewed for this dissertation. Aims : Aims of this dissertation were to : 1) identify the risk factors of lymphedema among breast cancer survivors in the WHEL Study, 2) examine the psychosocial impact of breast cancer -related lymphedema among participants in the WHEL Study, and 3) examine breast cancer patient compliance with a health care provider referral for an occupational therapy (OT) lymphedema consult. Methods : This study employed quantitative research methods to investigate lymphedema among breast cancer survivors. For aims 1 and 2, risk factors of lymphedema and the psychosocial impact of lymphedema among WHEL Study participants were assessed using bivariate analyses and logistic regression modeling. For the third aim, a retrospective chart review was conducted to examine patient compliance with attending an OT lymphedema consult. Results : This dissertation project found that 28.5% of WHEL Study participants self-reported lymphedema. Risk factors of lymphedema identified were body mass index greater than 25 kg/m², the removal of 11 or more lymph nodes, and breast cancer surgery plus radiation therapy. Also this dissertation provided new evidence that women with lymphedema-related distress had higher odds of reporting lower physical and mental health scores than women without lymphedema. Additionally, 20.5% of breast cancer patients were not compliant with attending an OT lymphedema consult after receiving a referral; non-attenders were more likely to have fewer lymph nodes removed compared to attenders. Conclusions : This dissertation project provided an in-depth investigation into breast cancer-related lymphedema. The knowledge gained by this study provides public health professionals and health care providers critical information to guide decisions and interventions related to the prevention and treatment of lymphedema