title: Psychological consequences of lymphoedema associated with breast cancer: a prospective cohort study.
abstract: BACKGROUND
  The aim of this prospective cohort study of women attending a rehabilitation course at the Dallund Rehabilitation Centre was to explore the emotional and psychological aspects of living with lymphoedema, expressed as psychological distress, poorer quality of life and poorer self-reported health.
  
  
  METHODS
  Between November 2002 and January 2007 within the FOCARE study, self-completed questionnaires were collected 3 weeks before and 6 and 12 months after the rehabilitation course to elicit sociodemographic, physical and lifestyle information and responses to three psychometric tests. The population consisted of 633 women, 125 with and 508 without verified lymphoedema (time since surgery, 1 month-5 years). The population was reduced to 553 women at the first follow-up and 494 at the second.
  
  
  RESULTS
  Multivariate analysis showed that, in comparison with women without lymphoedema, those with lymphoedema had a 14% higher risk for scoring one level higher on the POMS-SF test, a 9% higher probability of scoring one point lower on the quality of life scale and a 29% higher likelihood of reporting poorer or bad health than women without lymphoedema. These findings were seen at all three measurement times.
  
  
  CONCLUSIONS
  In this cohort of women with breast cancer, women with lymphoedema after surgery for breast cancer had significantly worse overall emotional well-being and adjustment to life compared to women without lymphoedema.
authors.affiliation: Department of Psychosocial Cancer Research, Institute of Cancer Epidemiology, Danish Cancer Society, Strandboulevarden 49, DK-2100 Copenhagen, Denmark. vassard@cancer.dk
authors.forename: Ditte
authors.initials: D
authors.lastname: Vassard
authors.forename: Maja Halgren
authors.initials: MH
authors.lastname: Olsen
authors.forename: Line
authors.initials: L
authors.lastname: Zinckernagel
authors.forename: Jette
authors.initials: J
authors.lastname: Vibe-Petersen
authors.forename: Susanne Oksbjerg
authors.initials: SO
authors.lastname: Dalton
authors.forename: Christoffer
authors.initials: C
authors.lastname: Johansen
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D000368:Aged; D000970:Antineoplastic Agents / Q000627:therapeutic use; D001943:Breast Neoplasms / Q000188:drug therapy / Q000523:psychology* / Q000601:surgery; D004644:Emotions; D005260:Female; D006304:Health Status; D006801:Humans; D008209:Lymphedema / Q000523:psychology*; D008875:Middle Aged; D011446:Prospective Studies; D011788:Quality of Life; D013315:Stress, Psychological; D011795:Surveys and Questionnaires
chemical_list: D000970:Antineoplastic Agents