ArticleJournal of cancer survivorship : research and practice2019
Drivers of cost differences between US breast cancer survivors with or without lymphedema.
Article in Journal of cancer survivorship : research and practice, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 21 papers, 2 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
21 citing papers in PubMed, 2 syntheses or guidelines pooled it, 38 citations in OpenAlex.
- Immediate Lymphatic Reconstruction (ILR) for the Prevention of Lymphedema: A Meta-analysis of Prospective Clinical Trials.Annals of surgical oncology · 2026Pooled it
- Financial toxicity experienced by patients with breast cancer-related lymphedema: a systematic review.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2023Pooled it
- A dynamic nomogram predicting persistent breast cancer-related lymphedema: a retrospective cohort study in China.Breast cancer (Tokyo, Japan) · 2026Article
- Disparities in Breast Cancer-related Lymphedema: A Systematic Review of Inequities and Barriers in Care.Plastic and reconstructive surgery. Global open · 2025Article
- Developing the Short-Form of Lymphedema Needs Questionnaire for Iranian Breast Cancer Patients.Cancer medicine · 2025Article
- Effectiveness of isometric muscle training combined with manual lymphatic drainage on secondary lower extremity lymphedema following gynecologic cancer surgery.Frontiers in bioengineering and biotechnology · 2025Article
- The impact of lymphedema severity on shoulder joint function and muscle activation patterns in breast cancer survivors: a cross-sectional study.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2024Observational
- The effect of compression therapies and therapeutic modalities on lymphedema secondary to cancer: a rapid review and evidence map.Medical oncology (Northwood, London, England) · 2024Review
- Etiology and treatment of cancer-related secondary lymphedema.Clinical & experimental metastasis · 2024Review
- Article
- Healthcare costs and utilization associated with pain among breast cancer survivors: a propensity score matched cohort study using SEER-Medicare data.Journal of cancer survivorship : research and practice · 2023Article
- Retrospective study on the trajectories of lower limb volume after outpatient-based complex decongestive therapy in post-operative gynecological cancer patients with lymphedema.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2023Article
- MRI of Lymphedema.Journal of magnetic resonance imaging : JMRI · 2023Review
- Neighborhood socioeconomic status and low-value breast cancer care.Journal of surgical oncology · 2022Article
- Prediction of breast cancer-related lymphedema by dermal backflow detected with near-infrared fluorescence lymphatic imaging.Breast cancer research and treatment · 2022Observational
- Side effect prediction based on drug-induced gene expression profiles and random forest with iterative feature selection.The pharmacogenomics journal · 2021Article
- A National Survey of Breast Surgeons and Radiation Oncologists on Contemporary Axillary Management in Mastectomy Patients.Annals of surgical oncology · 2021Article
- Addressing financial toxicity in oncology care.Journal of hospital management and health policy · 2021Article
- Statistical properties of minimal sufficient balance and minimization as methods for controlling baseline covariate imbalance at the design stage of sequential clinical trials.Statistics in medicine · 2020Article
- Article
Corrections and comments
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Authors and funding
10 authors at 7 institutions in 1 country.
Funding
Abstract
purposeBreast cancer-related lymphedema is an adverse effect of breast cancer surgery affecting nearly 30% of US breast cancer survivors (BCS). Our previous analysis showed that, even 12 years after cancer treatment, out-of-pocket healthcare costs for BCS with lymphedema remained higher than for BCS without lymphedema; however, only half of the cost difference was lymphedema-related. This follow-up analysis examines what, above and beyond lymphedema, contributes to cost differences.
methodsThis mixed methods study included 129 BCS who completed 12 monthly cost diaries in 2015. Using Cohen's d and multivariable analysis, we compared self-reported costs across 13 cost categories by lymphedema status. We elicited quotes about specific cost categories from in-person interviews with 40 survey participants.
resultsCompared with BCS without lymphedema, BCS with lymphedema faced 122% higher mean overall monthly direct costs ($355 vs $160); had significantly higher co-pay, medication, and other out-of-pocket costs, lower lotion costs; and reported inadequate insurance coverage and higher costs that persisted over time. Lotion and medication expenditure differences were driven by BCS' socioeconomic differences in ability to pay.
conclusionsElevated patient costs for BCS with lymphedema are for more than lymphedema itself, suggesting that financial coverage for lymphedema treatment alone may not eliminate cost disparities. IMPLICATIONS FOR CANCER SURVIVORS: The economic challenges examined in this paper have long been a concern of BCS and advocates, with only recent attention by policy makers, researchers, and providers. BCS identified potential policy and programmatic solutions, including expanding insurance coverage and financial assistance for BCS across socioeconomic levels.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.