Health-Related Quality of Life and Associated Factors in Long-Term Breast Cancer Survivors With and Without Lymphedema: A Cross-Sectional Study.

Breast cancer-related lymphedema is a common long-term complication of breast cancer treatment that may continue to affect survivors well beyond active treatment. This study compared health-related quality of life between long-term breast cancer survivors with and without lymphedema and examined factors associated with poorer quality of life in a hospital-based cross-sectional study. Women who had undergone definitive breast cancer surgery at least 5 years earlier were recruited from outpatient and follow-up services at Shaoxing People's Hospital. Lymphedema status was determined using predefined criteria based on symptom duration and objective upper-limb measurements. Health-related quality of life was assessed using the Functional Assessment of Cancer Therapy-Breast (FACT-B), the EQ-5D-5L, and the EQ visual analogue scale (EQ-VAS). Clinical, treatment-related, and symptom-related variables were collected for adjusted analyses. Among 268 long-term breast cancer survivors, 69 were classified as having lymphedema and 199 as not having lymphedema. Participants with lymphedema had lower breast cancer-specific and generic health-related quality-of-life scores than those without lymphedema. In adjusted analyses, lymphedema status and pain remained independently associated with lower FACT-B total scores. These findings indicate that lymphedema remains associated with poorer health-related quality of life in long-term breast cancer survivors and support continued symptom-oriented surveillance during survivorship.