An Initiative for the Early Detection and Intervention of Postoperative Lymphedema in Patients With Breast Cancer by Occupational and Physical Therapists.

Background Early detection and treatment of lymphedema is essential because once symptoms develop, it is a lifelong condition that is increasingly difficult to manage as the disease progresses. This study examined the effectiveness of an initiative whereby occupational and physical therapists identified possible lymphedema cases early and referred patients to physicians for intervention. Methods The subjects of this study were 107 consecutive breast cancer patients who underwent axillary lymph node dissection at our hospital between April 2020 and June 2021, and received rehabilitation intervention postoperatively. Occupational and physical therapists evaluated the patient's upper extremity function postoperatively and recommended that a physician examine patients with suspected lymphedema. Thereafter, a doctor examined the patient, and a nurse provided lymphedema education, including guidance on activities of daily living, skincare, and lymphatic drainage to prevent the lymphedema from worsening. Effectiveness was based on upper extremity circumference and lymphedema staging. Results We were able to refer 33 patients with suspected lymphedema to a doctor. These patients received medical attention and early intervention by nurses. There was no significant improvement in the upper extremity circumference due to the outpatient intervention, but no worsening either. Conclusions Postoperative breast cancer patients are at risk of developing lymphedema after discharge from the hospital. Postoperative assessment by occupational and physical therapists led to the detection of lymphedema at an early stage. As a result, patients were able to prevent the lymphedema from worsening through early treatment, and this intervention method was found to be effective to a certain degree. Therefore, this method is a useful system for identifying and managing lymphedema.