title: Association between lymphedema self-care adherence and lymphedema outcomes among women with breast cancer-related lymphedema.
abstract: OBJECTIVE
  The aim of this study was to determine whether adherence to self-care 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.
  
  
  METHODS
  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 (Ptrend = 0.79), 5% or greater decrease in the sum of interlimb arm circumferences (Ptrend = 0.47), 10% or greater decrease in bioimpedence spectroscopy (Ptrend = 0.83), 1 or greater decrease in self-reported lymphedema symptoms (Ptrend = 0.91), or therapist-defined lymphedema exacerbation requiring treatment (Ptrend = 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.
authors.affiliation: From the University of Pennsylvania, Philadelphia, Pennsylvania (JCB, AK, JCT, ABT, KHS); Mayo Clinic, Rochester, Minnesota (ALC); and University of British Columbia, Vancouver, British Columbia, Canada (SRH).
authors.forename: Justin C
authors.initials: JC
authors.lastname: Brown
authors.forename: Anagha
authors.initials: A
authors.lastname: Kumar
authors.forename: Andrea L
authors.initials: AL
authors.lastname: Cheville
authors.forename: Julia C
authors.initials: JC
authors.lastname: Tchou
authors.forename: Andrea B
authors.initials: AB
authors.lastname: Troxel
authors.forename: Susan R
authors.initials: SR
authors.lastname: Harris
authors.forename: Kathryn H
authors.initials: KH
authors.lastname: Schmitz
mesh_terms: D000368:Aged; D001943:Breast Neoplasms / Q000150:complications* / Q000601:surgery; D005260:Female; D006801:Humans; D016014:Linear Models; D008209:Lymphedema / Q000209:etiology / Q000534:rehabilitation*; D008875:Middle Aged; D010349:Patient Compliance; D011183:Postoperative Complications / Q000534:rehabilitation; D011446:Prospective Studies; D012648:Self Care; D016896:Treatment Outcome; D014891:Weight Lifting