Impact of breast cancer-related lymphedema on working women

Support Care Cancer. 2020 Jan;28(1):79-85. doi: 10.1007/s00520-019-04804-2. Epub 2019 Apr 13.

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.

MeSH terms

  • Adaptation, Physiological / physiology
  • Adult
  • Aged
  • Arm
  • Breast Cancer Lymphedema / epidemiology*
  • Breast Cancer Lymphedema / psychology
  • Breast Cancer Lymphedema / therapy
  • Breast Neoplasms / complications*
  • Breast Neoplasms / epidemiology*
  • Breast Neoplasms / pathology
  • Breast Neoplasms / therapy
  • Ergonomics
  • Female
  • Humans
  • Middle Aged
  • Range of Motion, Articular / physiology
  • Surveys and Questionnaires
  • Upper Extremity
  • Women, Working / statistics & numerical data*
  • Work / physiology*
  • Work / psychology
  • Work / statistics & numerical data
  • Workplace / psychology
  • Workplace / standards
  • Workplace / statistics & numerical data