Psychosocial aspects of upper extremity lymphedema in women treated for breast carcinoma

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Abstract
Lymphedema of the upper extremity following breast carcinoma is highly distressing and disabling. A review is presented of the literature on psychosocial aspects of lymphedema. Studies have shown that women who develop lymphedema exhibit higher levels of psychological, social, sexual, and functional morbidity than women with breast carcinoma who do not develop this complication. Women who have poor social support, pain, lymphedema in the dominant hand, and/or a passive and avoidant coping style report the highest levels of disability. Due to the mobidity of lymphedema once it develops, prevention and information given early are extremely important. However, the recommendations made to women sometimes involve considerable changes in lifestyle but are not based on solid, prospective evidence. In addition, how to best impart and time information about lymphedema pre- and postoperatively require investigation. In this paper, the authors discuss the psychological and functional impact of lymphedema and strategies for intervention and research to help women prevent the condition or enhance coping with it once it develops. Cancer 1998;83:2817-2820. © 1998 American Cancer Society.