Frequency of self-reported symptoms in patients with and without breast cancer-related lymphoedema and their associations with the outcomes of objective lymphoedema assessments.

OBJECTIVES: Breast cancer is a major health burden, and breast cancer-related lymphoedema (BCRL) is a potentially persistent complication that may cause swelling, heaviness, tightness, pain and functional and psychological limitations. This study compared the frequency of self-reported symptoms between patients with and without BCRL and examined associations between symptom severity and distress and objective lymphoedema measures. METHODS: A total of 120 women who completed primary cancer treatment were included (n=68 with BCRL; n=52 without BCRL). Symptom severity and distress were assessed using the Visual Analogue Scale. Arm volume, the Lymphoedema Index (L-Dex) derived from bioimpedance spectroscopy and local tissue water (LTW) assessed by tissue dielectric constant were measured. Group differences were analysed using the χ2 test, and associations using Spearman's correlation. Statistical significance was set at p<0.05. RESULTS: Swelling (86.8% vs 44.2%, χ²=24.60, p<0.001), heaviness (89.7% vs 46.2%, χ²=27.00, p<0.001), tightness (79.4% vs 53.8%, χ²=8.90, p=0.003) and pain (79.4% vs 57.7%, χ²=6.61, p=0.010) were significantly more frequent in the BCRL than non-BCRL group. Weak-to-moderate significant correlations were observed between symptom severity and distress related to swelling, heaviness, and tightness and arm volume difference (r=0.34-0.52, p<0.001) and L-Dex scores (r=0.33-0.46, p<0.001), and arm and forearm LTW ratios (r=0.26-0.37, p=0.006 to <0.001). CONCLUSIONS: Self-reported symptoms were more prevalent in patients with BCRL. Despite significant but weak-to-moderate associations with objective measures, these findings highlight that symptom reporting provides valuable complementary information and should be interpreted alongside objective assessments in the evaluation of BCRL.