Impact of internet-based nursing interventions on the prevention of postoperative lymphedema in breast cancer patients: a cohort study.

purposeThis study aimed to investigate the association between internet-based nursing guidance frequency and postoperative upper limb lymphedema risk in breast cancer patients, and identify influencing factors.

methodsA retrospective cohort study included 208 female patients who underwent breast and lymph node surgery (2020-2021). Univariate and multivariate logistic regression analyses were used to assess associations with lymphedema, defined as an arm circumference difference ≥ 2 cm. Internet-based guidance via WeChat included daily education manuals, weekly video exercises, and monthly assessments, with frequency categorized as 0, 1-2, or ≥ 3 times/week.

resultsDuring a 12-month period, 24% (50/208) developed lymphedema. Multivariate analysis identified the following independent risk factors: high BMI (OR 7.924, 95% CI 3.197-19.638), axillary lymph node dissection (OR 6.144, 95% CI 2.117-17.838), radiotherapy (OR 4.209, 95% CI 1.615-10.971). Urban residents had a lower risk of lymphedema compared to rural residents (OR 0.394, 95% CI 0.168-0.923). Receiving guidance 1-2 times per week, compared with ≥3 times per week, was associated with a higher risk of lymphedema (OR 9.752, 95% CI 3.158-30.111); receiving no guidance, compared with ≥3 times per week, was also associated with an increased risk (OR 4.068, 95% CI 1.346-12.296). Socioeconomic factors (including lower education level and income) were correlated with a higher risk.

conclusionHigh BMI, axillary lymph node dissection, and radiotherapy are highly associated with the occurrence of lymphedema after breast cancer surgery, while urban residence and high-frequency internet-based nursing guidance are associated with a lower probability of lymphedema. Future randomized controlled trials are needed to validate the preventive effects of digital health interventions.