title: Financial cost of lymphedema borne by women with breast cancer.
abstract: Our study examines the financial cost of lymphedema following a diagnosis of breast cancer and addresses a significant knowledge gap regarding the additional impact of lymphedema on breast cancer survivors.
  
  
  
  An online national survey was conducted with 361 women who had either breast cancer without lymphedema (BC) (group 1, n = 209) or breast cancer with lymphedema (BC+LE) (group 2, n = 152). Participant recruitment was supported by the Breast Cancer Network Australia and the Australasian Lymphology Association.
  
  
  
  Both breast cancer and lymphedema result in significant out-of-pocket financial costs borne by women. Of patients with BC+LE, 80% indicated that their breast cancer diagnosis had affected them financially compared with 67% in the BC group (P < .020). For patients with lymphedema, over half (56%) indicated that this specific additional diagnosis to their breast cancer affected them financially and that costs increased with lymphedema severity. The cost of compression garments formed a large proportion of these costs (40.1%). The average number of attendances to a therapist each year was 5.8 (range, 0-45). Twenty-five patients (16.4%) had an episode of cellulitis in the past year. The incidence of cellulitis was 7.7% in 91 patients with subclinical or mild lymphedema compared with 29.5% of 61 patients with more extensive lymphedema (P < .001). The average out-of-pocket financial cost of lymphedema care borne by women was A$977 per annum, ranging from A$207 for subclinical lymphedema to over A$1400 for moderate or severe lymphedema.
  
  
  
  This study identifies an additional detrimental effect of lymphedema on women in terms of financial costs.
authors.affiliation: Department of Clinical Medicine, Faculty of Medicine and Health Sciences, Macquarie University, Sydney, New South Wales, Australia.
authors.forename: John
authors.identifier: 0000-0003-3208-3966
authors.initials: J
authors.lastname: Boyages
authors.affiliation: Faculty of Business and Economics, Macquarie University, Sydney, New South Wales, Australia.
authors.forename: Ying
authors.initials: Y
authors.lastname: Xu
authors.affiliation: Faculty of Business and Economics, Macquarie University, Sydney, New South Wales, Australia.
authors.forename: Senia
authors.initials: S
authors.lastname: Kalfa
authors.affiliation: Department of Clinical Medicine, Faculty of Medicine and Health Sciences, Macquarie University, Sydney, New South Wales, Australia.
authors.forename: Louise
authors.initials: L
authors.lastname: Koelmeyer
authors.affiliation: Centre for the Health Economy, Macquarie University, Sydney, New South Wales, Australia.
authors.forename: Bonny
authors.initials: B
authors.lastname: Parkinson
authors.affiliation: Macquarie University Hospital, Macquarie University, Sydney, New South Wales, Australia.|Mt Wilga Private Hospital, Hornsby, New South Wales, Australia.
authors.forename: Helen
authors.initials: H
authors.lastname: Mackie
authors.affiliation: Faculty of Business and Economics, Macquarie University, Sydney, New South Wales, Australia.
authors.forename: Hector
authors.initials: H
authors.lastname: Viveros
authors.affiliation: Australian Institute for Business and Economics, Faculty of Business, Economics and Law, University of Queensland, St Lucia, Queensland, Australia.
authors.forename: Paul
authors.initials: P
authors.lastname: Gollan
authors.affiliation: Faculty of Business and Economics, Macquarie University, Sydney, New South Wales, Australia.
authors.forename: Lucy
authors.initials: L
authors.lastname: Taksa
mesh_terms: D001315:Australia; D001943:Breast Neoplasms / Q000150:complications* / Q000628:therapy; D000073116:Cancer Survivors / Q000706:statistics & numerical data; D017281:Cost of Illness; D005260:Female; D005102:Health Expenditures / Q000706:statistics & numerical data*; D006801:Humans; D008209:Lymphedema / Q000191:economics* / Q000209:etiology*; D008875:Middle Aged; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires
keywords: cancer; cellulitis; cost; lymphedema; oncology