Lymphedema Risk Reduction for Chinese Breast Cancer Survivors

New York University School Of Medicine, New York NY

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Abstract

Lymphedema (LE) remains a major health problem affecting thousands of breast cancer survivors. Significantly lower quality of life is observed in survivors with LE than those without. LE following breast cancer treatment is characterized by an accumulation of lymph fluid in the interstitial spaces of the affected limb and areas, leading to a syndrome of abnormal swelling and multiple distressing symptoms. Survivors with fluid accumulation are at greater risk for repeated cellulitis, infections, and lymphangitis, which creates financial and economic burdens not only to survivors but also to the healthcare system. Preoperative assessment, educational and behavioral interventions are showing effectiveness to maintain limb volume, ameliorate LE symptoms and promote early detection. This project proposes to improve clinical practice by implementing and preliminarily evaluating an educational and behavioral intervention (The Optimal YOU) to enhance LE risk reduction among Chinese-speaking breast cancer survivors. The Optimal YOU intervention focuses on promoting lymph flow, preventing inflammation-infection, and maintaining optimal body mass index. Evaluation of the feasibility, acceptability, and effectiveness of the intervention has been demonstrated in English-speaking breast cancer survivors. Yet in its current form, this very promising program is not available to non-English-speaking women. The aims of the project are to: (1) translate and adapt The Optimal YOU intervention from English language into Chinese language; (2) Preliminarily evaluate the feasibility and acceptability of implementation of the intervention through focus group approach; and (3) preliminarily examine the intervention on the process of participation, attrition, satisfaction, cost, and intervention fidelity as well as the effectiveness by conducting a randomized controlled clinical trial and comparing the intervention outcomes at preoperative baseline, 4-8 weeks, 6 months, and 12 months follow-up. Special attention will be on the identification of cultural and linguistic factors that promote or impede the implementation of the intervention.