The Relationship Between Upper-Limb Lymphedema and Fatigue Among Breast Cancer Survivors

• Published in: European journal of cancer care 2024-12, Vol.2024
• Main Authors: Soltanipur, Masood, Yarmohammadi, Hossein, Shahshenas, Sina, Abbasvandi, Fereshteh, Montazeri, Ali, Sheikhi, Zahra
• Format: Article
• Language: English
• Subjects: Analysis; Body mass index; Breast cancer; Cancer survivors; Cancer therapies; Chemotherapy; Cognitive ability; Comorbidity; Correlation; Data collection; Diagnostic systems; Effectiveness; Fatigue; Global health; Lymph nodes; Lymphedema; Medical records; Public health; Quality of life; Questionnaires; Radiation therapy; Variables; Womens health; World health
• ISSN: 0961-5423; 1365-2354
• DOI: 10.1155/ecc/3452139

Background: Breast cancer survivors (BCSs) often face long-term complications, with upper-limb lymphedema and cancer-related fatigue (CRF) being challenging. This study aimed to investigate the relationship between upper-limb lymphedema and fatigue among BCSs. Method: This cross-sectional study was performed on 102 BCSs, of which 31 (30.4%) had breast cancer-related lymphedema. Duration, stage, and excess volume were considered as indicators of breast cancer-related lymphedema severity. QoL was measured using the EORTC QLQ-C30. The score of the fatigue symptom scale was used based on EORTC QLQ-C30 for CRF assessment. Also, the brief fatigue inventory was used to measure the severity of fatigue among participants. Results: The mean fatigue symptom scale and brief fatigue inventory scores were 37.90±24.59 and 3.69±1.25, respectively. The mean fatigue symptom scale was significantly different among BCSs with BMI≤25 and BMI>25 (29.59±24.49 vs. 41.51±23.88, p=0.026). Also, the mean brief fatigue inventory was significantly different among BCSs with the number of dissected lymph nodes (LNs) ≤ 5 and>5 (3.52±1.18 vs. 4.08±1.34, p=0.042). Additionally, women with breast cancer-related lymphedema had significantly higher scores of fatigue symptom scale and brief fatigue inventory (46.59±27.12 vs. 34.11±22.56, p=0.03, and 4.75±1.21 vs. 3.22±0.96, p=0.001, respectively). Except for a weak correlation between BMI and fatigue symptom scale and brief fatigue inventory (r: 0.279, p=0.004, and r: 0.313, p=0.001, respectively), there was no other significant relationship between CRF and study variables such as breast cancer-related lymphedema duration, stage, and excess volume. Meanwhile, fatigue symptom scale and brief fatigue inventory were significantly correlated with global health and functional scale scores of EORTC QLQ-C30. The ROC curve which models the diagnostic efficacy for fatigue symptom scale showed an AUC of 0.634 (p=0.034, 95% CI: 0.510-0.759), while the ROC curve which models the diagnostic efficacy for brief fatigue inventory showed an AUC of 0.821 (p