Approximately 25% of women who undergo ALND develop lymphedema within three years of the intervention, and about 55% of the patients who undergo the dissection of the sentinel lymph node feel a numbness within five years after the operation (McLaughlin et al., 2008).
These statistics reinforce the needà of a rating from the continue several years after the surgery. Recommendations for follow-up include a physical examination and measurements one month after surgery and then at intervals of three months for 18 months after the intervention (StoutGergich et al., 2008; Torres Lacomba et al., 2010).
to Continue the follow-up può be difficult for some patients because of lack of motivation, financial stress, transport or distance and availabilityà for appointments (Papadopoulou et al., 2012). The thorough instruction of the patient, the strengthening of the interventions and the follow-up is important because of the reduction of the compliance of the care of sé long-term observed in patients with breast cancer. (International Consensus, 2006; Papadopoulou et al., 2012).
Qualityà of life in patients with lymphedema
The qualityà of life includes the physical appearance, psychology, socialità and the spiritual well-being. Patients who develop lymphedema are at risk of decrease of qualityà of life and functional status because of physical changes such as disfigurement, discomfort, disabilityà impossibilityà to perform the activities; of daily life. (International Consensus, 2006; Ryan et al., 2012; Taylor et al., 2006).
the alterations in The psychological well-being are also influenced by the changing body, which creates an emotional stress (Ryan et al., 2012; Taylor et al., 2006). The perception of patients with lymphedema is also an important factor for the qualityà psychological and social dimensions of life (McLaughlin et al., 2008).
lymphedema in the dominant arm is probably less of a problem for the patient in relation to lymphoedema in the dominant part and physicians should be aware that patients may report fewer symptoms in the arm, less dominant, McLaughlin et al., 2008).
the improvement of The qualityà of life has been observed in patients who have received therapy and education, compared to those who received only education. (NLN, 2011; Torres Lacomba et al., 2010). The current model of traditional depends on the patient seeking treatment when there are symptoms and signs of lymphedema, which canò result in delay in diagnosis and treatment and therefore have a negative impact on the qualityà of life.(Stout et al., 2012). A model of surveillance allows for the early diagnosis and intervention, thereò leads to increased or maintained functional status, and qualityà of life. (Stout et al., 2012).
Implications for nursing and conclusions
As physicians, oncology nurses are a key member of the interdisciplinary team and are in a unique position to provide instructions to the patient, comprehensive assessments and follow-up for patients with breast cancer, especially those at risk of lymphedema. Oncology nurses provide education to the patient thereò which concerns the risk factors, prevention, treatment options and self-management (Ryan et al., 2012). Set expectations and provide the interventions should be done before and after the treatment (Ryan et al., 2012).
oncology nurses can perform assessments, with the aim of creating the adequate references to the other members of the interdisciplinary team (Ryan et al., 2012). Early diagnosis, intervention and adequate care of the sé può help prevent the progression of lymphedema, and have a positive effect on the qualityà of life (Ryan et al., 2012).
oncology nurses are members of the key interdisciplinary team in the management and treatment of lymphedema. Oncology nurses involved in the rehabilitation from cancer, and survival are the key for the identification of breast cancer patients at risk of lymphedema: provide a complete evaluation and early intervention, and coordinating with appropriate references to the members of the interdisciplinary team for the management of lymphoedema support the self-management of the lymphedema patient. This patient-centred approach può improve functional status and improve the qualityà of life.
Diagnosis and treatment of lymphedema in patients with breast cancer
Care and treatment of lymphedema in women with breast cancer
Fibroadenoma al seno: cos’è, cause e cure
may 16, 2015