Overview
Breast cancer is one of the most common cancers among women worldwide, with surgery being a primary treatment. However, surgical tumor resection combined with lymph node dissection often leads to upper extremity lymphedema as a complication. This study aims to evaluate the effectiveness of preoperative rehabilitation exercise on upper limb function, lymphedema severity, quality of life, and post-discharge care needs in breast cancer patients undergoing surgery.
Participants will be assigned to either an experimental group receiving individualized preoperative rehabilitation exercise instruction or a control group receiving standard clinical nursing education. Outcomes will be measured across seven time points from pre-operation up to one year post-surgery.
Description
- Background
Surgical resection combined with axillary lymph node dissection in breast cancer patients frequently causes upper extremity lymphedema, negatively impacting physical function and quality of life. Implementing upper limb rehabilitation exercises prior to surgery may facilitate functional recovery and reduce postoperative complications.
- Objectives
-
- To evaluate the effect of preoperative upper limb rehabilitation exercise on reducing postoperative lymphedema in patients with breast cancer.
- To examine changes in quality of life and home care needs following preoperative rehabilitation intervention.
- To analyze factors influencing upper extremity function, lymphedema severity, quality of life, and care needs among breast cancer surgical patients.
Methods \& Procedures:
This longitudinal quasi-experimental study will recruit 105 patients scheduled for tumor resection with axillary lymph node dissection at National Taiwan University Hospital and National Taiwan University Hospital Cancer Center.
- Experimental Group: Receives individualized preoperative instruction and guidance on upper limb rehabilitation exercises starting preoperatively.
- Control Group: Receives routine clinical nursing education preoperatively or on postoperative Day 1 according to standard ward procedures.
Data Collection Timeline:
Data will be collected at seven time points:
- Pre-operation (1 week / 1 day prior to surgery)
- Postoperative Day 1
- Postoperative Week 2 (first clinic visit)
- Postoperative Week 4
- Postoperative Month 3
- Postoperative Month 6
- Postoperative Year 1
Assessment Parameters:
Measurements include arm circumference, handgrip strength, shoulder range of motion, functional activities of daily living (ADL), lymphedema-related symptoms, quality of life, and care needs. Descriptive statistics and Generalized Estimating Equations (GEE) will be used to analyze treatment outcomes over time.
Eligibility
Inclusion Criteria:
- Diagnosed with malignant breast cancer confirmed by post-surgical tissue examination.
- Receiving primary surgery, including tumor resection combined with axillary lymph node dissection.
- Age 20 years or older.
- Conscious, able to communicate in Mandarin or Taiwanese, aware of diagnosis, capable of completing questionnaires and participating in interventions, and signed informed consent.
Exclusion Criteria:
- Severe cognitive impairment or unaware of diagnosis, unable to complete questionnaires or correctly execute intervention measures.
- Patients in the control group who independently schedule outpatient rehabilitation after returning home.
- Unable to communicate in Mandarin or Taiwanese.
- Undergoing breast reconstruction surgery.
