Abstract
Breast-cancer-related lymphedema (BCRL) is a common complication of breast cancer treatment. Informing patients about BCRL can contribute to decrease their risk of developing the condition or prevent it from progressing further. In order to educate patients about BCRL effectively, clinical knowledge of clinicians must be adequate. In study, we aimed to reflect BCRL knowledge and attitude of Turkish primary care physicians (PCPs). This questionnaire-based study was conducted by face-to-face interview method. The participants included actively working PCPs from all parts of Turkey. The questionnaire elicited data on physicians’ demographics, the BCRL knowledge, self-reported BCRL knowledge, referral patterns, and education. A total of 314 PCPs with a mean age of 36.9 % ± 8.1 years (mean ± standard deviation) were included in the study. Median BCRL knowledge score of all study group was 15 (11–18) [median (25–75 % range)]. PCPs who received education about BCRL during their medical faculty and/or residency periods had significantly higher knowledge scores (p = 0.005). Of PCPs, 94.9 % indicated to make a BCRL referral for a breast cancer patient. Among them, 55 % preferred to make a referral to a general surgeon, 28.2 % to an oncologist, and 16.8 % to a physical medicine and rehabilitation specialist. Assessment of factors related with BCRL should be part of routine evaluation of patients with breast cancer in primary care. Education of PCPs about BCRL is warranted in order to improve the BCRL care.
Similar content being viewed by others
References
Ozmen V (2008) Breast cancer in the world and Turkey. J Breast Health 4:6–12
Fidaner C, Eser SY, Parkin DM (2001) Incidence in Izmir in 1993–1994: first results from Izmir cancer registry. Eur J Cancer 37:83–92
DeSantis C, Siegel R, Bandi P, Jemal A (2011) Breast cancer statistics. CA Cancer J Clin 61:409–418
Fu MR (2014) Breast cancer-related lymphedema: symptoms, diagnosis, risk reduction, and management. World J Clin Oncol 5:241–247
Lawenda BD, Mondry TE, Johnstone PA (2009) Lymphedema: a primer on the identification and management of a chronic condition in oncologic treatment. CA Cancer J Clin 59:8–24
Harris SR, Hugi MR, Olivotto IA, Levine M, Steering Committee for Clinical Practice Guidelines for the Care and Treatment of Breast Cancer (2001) Clinical practice guidelines for the care and treatment of breast cancer: 11. Lymphedema. CMAJ 164:191–199
Lymphedema MP (1997) Pathogenesis, prevention and treatment. Cancer Pract 5:32–38
Thomas-MacLean R, Miedema B, Tatemichi SR (2005) Breast cancer-related lymphedema: women’s experiences with an underestimated condition. Can Fam Physician 51:246–247
Ridner SH (2006) Pretreatment lymphedema education and identified educational resources in breast cancer patients. Patient Educ Couns 61:72–79
Fu MR, Chen CM, Haber J, Guth AA, Axelrod D (2010) The effect of providing information about lymphedema on the cognitive and symptom outcomes of breast cancer survivors. Ann Surg Oncol 17:1847–1853
Paskett ED, Stark N (2000) Lymphedema: knowledge, treatment, and impact among breast cancer survivors. Breast J 6:373–378
Tam EK, Shen L, Munneke JR, Ackerson LM, Partee PN, Somkin CP et al (2012) Clinician awareness and knowledge of breast cancer-related lymphedema in a large, integrated health care delivery setting. Breast Cancer Res Treat 131:1029–1038
Smith SL, Wai ES, Alexander C, Singh-Carlson S (2011) Caring for survivors of breast cancer: perspective of the primary care physician. Curr Oncol 18:218–226
Lacasse Y, Godbout C, Sériès F (2002) Health-related quality of life in obstructive sleep apnoea. Eur Respir J 19:499–503
Pelusi J (1997) The lived experience of surviving breast cancer. Oncol Nurs Forum 24:1343–1353
Beaulac SM, McNair LA, Scott TE, LaMorte WW, Kavanah MT (2002) Lymphedema and quality of life in survivors of early-stage breast cancer. Arch Surg 137:1253–1257
Pinto M, Gimigliano F, Tatangelo F, Megna M, Izzo F, Gimigliano R et al (2013) Upper limb function and quality of life in breast cancer related lymphedema: a cross-sectional study. Eur J Phys Rehabil Med 49:665–673
Passick SD, McDonald MV (1998) Psychosocial aspects of upper extremity lymphedema in women treated for breast carcinoma. Cancer 83:2817–2820
Stout NL, Binkley JM, Schmitz KH, Andrews K, Hayes SC, Campbell KL et al (2012) A prospective surveillance model for rehabilitation for women with breast cancer. Cancer 118:2191–2200
Keast DH, Despatis M, Allen JO, Brassard A (2014) Chronic oedema/lymphoedema: under-recognised and under-treated. Int Wound J. doi:10.1111/iwj.12224
Hua-Ping H, Jian-Rong Z, Zeng Q (2012) Factors associated with lymphedema among postmenopausal breast cancer survivors after radical mastectomy and axillary dissection in China. Breast Care (Basel) 7:461–464
Del Turco MR, Ponti A, Bick U, Biganzoli L, Cserni G, Cutuli B, Decker T et al (2010) Quality indicators in breast cancer care. Eur J Cancer 46:2344–2356
Ali Jadoo SA, Aljunid SM, Sulku SN, Nur AM (2014) Turkish health system reform from the people’s perspective: a cross sectional study. BMC Health Serv Res 14:30. doi:10.1186/1472-6963-14-30
Shaw RM, Thomas R (2014) The information needs and media preferences of Canadian cancer specialists regarding breast cancer treatment related arm morbidity. Eur J Cancer Care (Engl) 23:98–110
Kwan ML, Shen L, Munneke JR, Tam EK, Partee PN, André M et al (2012) Patient awareness and knowledge of breast cancer-related lymphedema in a large, integrated health care delivery system. Breast Cancer Res Treat 135:591–602
Korpan MI, Crevenna R, Fialka-Moser V (2011) Lymphedema: a therapeutic approach in the treatment and rehabilitation of cancer patients. Am J Phys Med Rehabil 90:69–75
Fialka-Moser V, Korpan M, Varela E, Ward A, Gutenbrunner C, Casillas JM et al (2013) The role of physical and rehabilitation medicine specialist in lymphoedema. Ann Phys Rehabil Med 56:396–410
Civelek GM, Adam M (2012) Knowledge of patients about physical medicine and rehabilitation attending a tertiary physical medicine and rehabilitation clinic. J Rheumatol Med Rehabil 22:56–59
Zandbelt LC, Smets EM, Oort FJ, Godfried MH, de Haes HC (2006) Determinants of physicians’ patient-centred behaviour in the medical specialist encounter. Soc Sci Med 63:899–910
Chalasani P, Downey L, Stopeck AT (2010) Caring for the breast cancer survivor: a guide for primary care physicians. Am J Med 123:489–495
Kaiser K, Rauscher GH, Jacobs EA, Strenski TA, Ferrans CE, Warnecke RB (2011) The import of trust in regular providers to trust in cancer physicians among white, African American, and Hispanic breast cancer patients. J Gen Intern Med 26:51–57
Sherman KA, Miller SM, Roussi P, Taylor A (2015) Factors predicting adherence to risk management behaviors of women at increased risk for developing lymphedema. Support Care Cancer 23:61–69
Del Giudice ME, Grunfeld E, Harvey BJ, Piliotis E, Verma S (2009) Primary care physicians’ views of routine follow-up care of cancer survivors. J Clin Oncol 27:3338–3345
Rurik I, Torzsa P, Ilyés I, Szigethy E, Halmy E, Iski G et al (2013) Primary care obesity management in Hungary: evaluation of the knowledge, practice and attitudes of family physicians. BMC Fam Pract 14:156. doi:10.1186/1471-2296-14-156
Conflict of Interest
None
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Mete Civelek, G., Aypak, C. & Turedi, O. Knowledge of Primary Care Physicians About Breast-Cancer-Related Lymphedema: Turkish Perspective. J Canc Educ 31, 687–692 (2016). https://doi.org/10.1007/s13187-015-0880-6
Published:
Issue Date:
DOI: https://doi.org/10.1007/s13187-015-0880-6