Dynamics of quality of life indicators after a rehabilitation course in patients with upper-limb lymphedema associated with radical treatment for breast cancer

Background. The development and implementation of effective long-term treatment strategies for secondary lymphedema associated with radical treatment for breast cancer remains a pressing issue in medical rehabilitation.

Objective. To study the impact of a comprehensive rehabilitation program on quality of life in patients with secondary lymphedema of the upper extremities, stages I-III, who underwent radical treatment for breast cancer.

Materials and methods. The study was conducted at the clinical site of the Federal State Institution National Medical Research Center for Rehabilitation and Balneology of the Ministry of Health of the Russian Federation and included 30 patients with lymphedema associated with radical treatment for breast cancer stages I-III, with an average age of 63.40 ± 10.85 years. The rehabilitation program included laser therapy, magnetic therapy, sessions with a clinical psychologist, group therapeutic exercises in the gym, occupational therapy, exercises on cycling equipment, and pneumatic compression procedures (10 sessions per course). The treatment duration was 12 days. A quality of life study was conducted using the LYMQOL ARM questionnaire. Limb circumferences were measured on the hand, lower and middle third of the forearm at symmetrical points on the affected and healthy limbs.

Results. Before treatment, patients with lymphedema associated with radical treatment for breast cancer had a deterioration in the overall quality of life score to 4.63 ± 1.21 points. After the rehabilitation course, a decrease in hand circumference by 3.54% (p < 0,0001), forearm circumference by 2.32% (p < 0,0001), and middle arm circumference by 3.25% (p < 0,0001) was noted. After the rehabilitation course, improvement was noted in all quality of life indicators (LYMQOL ARM): an improvement in the hand function score (p < 0.001); an improvement in the body appearance and perception score (p < 0.001); an improvement in the lymphedema symptoms score (p < 0.001); Emotional state/mood score (p < 0.001). Overall quality of life improved by 37.36% (p < 0,001).

Conclusions. The study of quality-of-life indicators in patients with lymphedema after rehabilitation using the LYMQOL ARM questionnaire in the Russian population confirmed its reliability and sensitivity in patients with lymphedema. Using this instrument to assess the effectiveness of rehabilitation increases the significance of the study, as lymphedema often impacts not only physical functioning but also significantly limits health-related psychosocial well-being in breast cancer survivors.

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