Sharon Krumm, PhD, RN, the Editor of Oncology Nursing, is administrator
and director of nursing, Johns Hopkins Oncology Center, and assistant
professor, Johns Hopkins University Schools of Medicine and Nursing. ONI is
pleased to announce the creation of an Editorial Advisory Board for Oncology
Nursing. Members are Catherine Coleman, RN, OCN, a consultant for breast
center development, Tiburon, California, and Mary McCabe, BSN, MA, acting
director, Office of Communications, National Cancer Institute, Be-thesda,
Maryland. See p. 27 for more about the board members.
WASHINGTONLymphedema in breast cancer survivors is more common and more
disabling than generally believed, according to Jane M. Armer, RN, PhD. In a
poster presented at the Oncology Nursing Society’s 27th Congress (abstract
187), Dr. Armer reported that in a group of women who were an average of 3
years post-treatment for breast cancer, 39% had a circumference difference of
2 cm or more between arms (sufficient for a diagnosis of lymphedema), and 40%
had a difference of between 1 and 2 cm, which some consider latent lymphedema.
The descriptive-correlational, cross-sectional study included 103 women
treated for breast cancer at a midwestern medical center. Mean age was 59
years (range, 31 to 88 years). Mean time since diagnosis was 3 years (range,
3 months to 41 years). A high proportion of these women reported signs and
symptoms of lymphedema. Forty of the 103 women developed lymphedema as
defined above. Two thirds (63%) of these women reported swelling, 60% had
limb heaviness, 45% had tenderness, and 38% had numbness (see
Table 1). Of
all 103 women receiving treatment, 55% reported current numbness, and 42%
reported limb tenderness in the past year (see Table 2).
Dr. Armer, associate professor, University of Missouri-Columbia Sinclair
School of Nursing and director of nursing research, Ellis Fischel Cancer
Center, found that women with lymphedema had significantly more swelling and
heaviness, while reports of numbness and tenderness in the lymphedema group
and the total group did not differ significantly.
"Post-breast cancer lymphedema is a chronic, distressful symptom that is
poorly understood, acknowledged, and addressed by health providers," Dr.
Armer said. This was illustrated by the study subject who, 41-years after her
diagnosis, said, "Going through treatment for breast cancer was nothing
compared to 39 years with lymphedema."
The researchers found that most of the study subjects did no self-care
activities to manage their signs and symptoms. Dr. Armer said that the
investigators have completed work comparing circumferences, water
displacement, and infrared laser perometry assessments of limb volume in
healthy women and in breast cancer survivors, with the goal of developing an
assessment tool to score risk and guide recommendations for self-care.