Proposed Topic (Most preferred): :
Clinical Safety and Quality Service I (Projects aiming to improve efficiency and effectiveness of care delivery to meet international standards)
Proposed Topic (Second preferred): :
Enhancing Partnership with Patients and Community (Projects initiated to engage patients / carers / community to improve efficiency / quality of care)
Authors (including presenting author) :
Wong WL (1), Yeung YK (2), Chun OK (1), Fung KY(2), Wong NS(1), Leung WC(2), Cheng MLI (1), Ng SW(2)
Affiliation :
1. The Breast Centre, department of Surgery, Kwong Wah Hospital
2. Physiotherapy department, Kwong Wah Hospital
Introduction :
Incidence of breast cancer is triple arising in Hong Kong from 1993. All the women who were treated for breast cancer are at life-time risk for lymphedema. Lymphedema can occur months or even many years after breast cancer treatment and may be triggered by infection or injury to the arm. Many breast cancer patients concern and worry about the physical, psychological and social impact of upper limb lymphedema after breast cancer surgery such as: limb swelling, numbness, heaviness, negative body image, reduce self-esteem and poor quality of life. Study result showed 92% breast cancer patient with early detection and intervention did not progress to chronic lymphedema. Therefore, timely, quality and seamless care can alleviate their suffering during the cancer journey.
Objectives :
The objectives are to 1. Prevention, 2. Early detection, 3. Early intervention, 4. Reduces the burden of chronic lymphedema on breast cancer patient.
Methodology :
A well-structured programme was designed by Kwong Wah Hospital breast care nurses and physiotherapists who were certified lymphedema practitioner.
Inclusion criteria: All breast cancer patients had surgery to the armpit including sentinel lymph node biopsy or axillary dissection.
Exclusion criteria: Breast cancer patients with metastatic disease or patients who did not have operation at axilla.
Patient invited to attend our monthly education talk at post–operative 4 months. The content of education talk includes skin care, weight control, diet recommendation, exercise teaching and clarify the myth of lymphedema. Advance technology is used by measuring the L-dex score to screen out subclinical lymphedema. For those patients who identify subclinical lymphedema, they will invite to join our designated exercise class held by physiotherapists for management and monitor the progress.
Result & Outcome :
BCRL is a challenge for both health care providers and survivors. Patients with subclinical lymphedema usually are asymptomatic despite impaired lymph transport but the condition is reversible. Prevention is better than cure. A structured program is designed with the collaborate with physiotherapist to prevent or identify early stage of lymphedema to minimize the impact of BCRL after breast cancer treatments. The program will implement in 2Q 2024 in Kwong Wah Hospital.
