Abstract

Objectives: This study aimed to identify the cognitive factors associated with the professional healthcare advice (PHCA) seeking behavior in breast cancer‐related lymphedema (BCRL).

Methods: From January 2018 to December 2018, patients with BCRL were prospectively enrolled for a cross‐sectional survey of lymphedema‐related perceived risks, lymphedema quality of life (LYMQoL), knowledge scale of lymphedema, and PHCA behavior at first clinical visit, 3 and 6 months postbaseline.

Results: A total of 180 patients including 100 (55.6%) patients underwent a vascularized lymph node transfer (VLNT) and 80 (44.4%) patients received compressive decongestive therapy (CDT) were enrolled. At 6 months of follow‐up, mean episodes of cellulitis (from 2.2 to 0.2 times/year), mean circumferential difference (7.8 ± 3.9%), wearing compression garments (from 29% to 0 %) in the VLNT group were statistically reduced than those in the CDT group (p = .01, <.01, and <.01, respectively). The overall LYMQoL had statistical improvement in VLNT group (p < .01). The short symptom duration, greater education level, less episodes of cellulitis, and higher knowledge of lymphedema were associated with increased adherence to PHCA (p = .03, .03, .02, and .01, respectively).

Conclusion: BCRL patients who sought PHCA had great control of lymphedema and improve their quality of life.

Main findings

• This study aimed to identify lymphedema symptoms and the knowledge level associated with PHCA (professional healthcare advice) ‐seeking behavior for BCRL in different time periods.
• The authors found that the knowledge of lymphedema and QoL were significantly improved and that these changes could be observed after the patient went to the clinic to seek lymphedema‐related health care advice.
• Steady improvement was noticed with time, especially in the VLNT (vascularised lymph node transfer) group.
• The reasons for the better outcomes in the VLNT group may be twofold: (1) early awareness of lymphedema problem: participants were conscious of other causes of symptom onset and became aware of their lymphedema issue earlier, and (2) back to normal life: returned to a daily routine without wearing a compression garment.
• Breast cancer survivors who received PHCA and understood lymphedema risk management were more likely to adhere to controlling lymphedema disease and improving QoL.