Association between lymphedema self-care adherence and lymphedema outcomes among women with breast cancer-related lymphedema

Objective: The aim of this study was to determine whether adherence to selfcare modalities for breast cancer-related lymphedema (BCRL) predicts BCRL outcomes among 128 breast cancer survivors who participated in the 12-mo physical activity and lymphedema trial. Design: This was a prospective cohort study. Adherence to ten BCRL self-care modalities, as recommended in the clinical practice guidelines for the management of BCRL, was assessed by a questionnaire at baseline. BCRL outcomes assessed at baseline and 12 mos included volumetry, circumferences, bioimpedence spectroscopy, the Norman lymphedema survey, and therapist-defined lymphedema exacerbations requiring treatment. Generalized linear models were used to estimate the relationship between adherence to BCRL self-care modalities and the likelihood of experiencing a BCRL outcome. Results: Adherence to BCRL self-care activities did not predict experiencing any BCRL outcomes at 12 mos. Levels of adherence to BCRL self-care modalities did not predict a 5%or greater decrease in interlimb volume (P_trend = 0.79),5%or greater decrease in the sum of interlimb arm circumferences (P_trend = 0.47), 10% or greater decrease in bioimpedence spectroscopy (P_trend = 0.83), 1 or greater decrease in self-reported lymphedema symptoms (P_trend = 0.91), or therapistdefined lymphedema exacerbation requiring treatment (P_trend = 0.84). Conclusions: Our findings suggest that levels of BCRL self-care adherence do not predict BCRL outcomes among breast cancer survivors with stable lymphedema who were followed for 12 mos.