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Impact of breast cancer–related lymphedema on working women

  • Stéphane VignesEmail author
  • Pascal Fau-Prudhomot
  • Laura Simon
  • Marie-Laure Sanchez-Bréchot
  • Maria Arrault
  • Fabrice Locher
Original Article

Abstract

Background

The professional impact of upper limb lymphedema, which affects 15–20% of women after breast cancer treatment, has been poorly evaluated.

Objective

To analyze lymphedema characteristics and global lymphedema- and/or sleeve-attributed impact (mildly inconvenient to severely debilitating) on professional activities, workplace relationships, and workstation ergonomics.

Methods

Patients received a standardized, anonymous, self-administered questionnaire at consultation/hospitalization for treatment in a specialized lymphedema management center.

Results

All 134 consecutive women (March/2015–March/2017; median age 54), with 53-month median lymphedema duration and 34% median excess volume, were included; 35% considered global impact (arm-use impairment) high. For high vs. low global impact during occupational activities, univariate analyses identified global impairment as being associated with the low (23.8%), intermediate (60%), or high (63.2%) (p < 0.01) arm-use level, while multivariate analyses retained intermediate (OR 6.9 [95% CI 1.1–118.1], p < 0.01) and high (OR 4.5 [95% CI 1.5–37.3], p < 0.05) vs. low arm-use level. Lymphedema affected the careers of 70 (52.2%) patients, mostly those with severely impaired arm movement (53.8% vs. 10.2, p < 0.001), without modifying their relationships with colleagues and superiors for 84 (62.7%). Highly impaired women reported changed relationships with colleagues (45% vs. 20%, p < 0.01) and superiors (43.6% vs. 16.9%, p < 0.01). Only 10 women’s (7.5%) job changes reflected lymphedema or its treatment. Workplace adaptations (53% ergonomic) were made for 36 (26.9%) patients, mostly those with greater arm-movement impairment (43.6% vs. 25.3%, p < 0.05), who were highly satisfied (86%).

Conclusion

Upper limb lymphedema can significantly impact work, sometimes upending careers. The rare workstation adaptations were beneficial. Occupational physicians should assess lymphedema-attributed difficulties to improve working conditions.

Keywords

Breast cancer Lymphedema Occupational activity 

Notes

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Department of LymphologyHôpital Cognacq-JayParisFrance
  2. 2.Department of EpidemiologyACMSSuresnesFrance

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