Journal of cancer survivorship : research and practice · 2026
Trajectories of lymphedema risk perception and their predictors in postoperative breast cancer survivors.
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Yang Yaru, An Yu, Han Mengyu, Lu Jingming, He Zhiqiang, Wang Tianyu, Xiao Hui, Ye Junxia, Chen Jingyu, Li Jin
Аннотация
BACKGROUND: Risk perception is considered an important component of patients' self-management in breast cancer-related lymphedema (BCRL). However, existing evidence is largely cross-sectional and provides limited understanding of how risk perception evolves over time in the early postoperative period.
OBJECTIVE: This study aimed to describe the level of lymphedema risk perception at discharge and to explore its change trajectories during the first 6 months after surgery in patients with breast cancer.
METHODS: Participants were recruited from two tertiary grade A hospitals in China and completed a baseline survey (questionnaires on demographic and clinical characteristics, lymphedema risk perception, health literacy, communication patterns, and perceived social support) and follow-up assessments (Lymphedema Risk Perception Questionnaire) at the 1st, 3rd, and 6th months postoperatively.
RESULTS: Among 225 patients completing baseline, 185 (82.3%) completed the 6-month follow-up. Risk perception showed moderate overall levels with an initial rise followed by decline. Three distinct trajectories emerged: high-gradually declining group, moderate-peaked group, and low-peaked group. Key predictors included education, health education exposure, treatment type, surgery, disease stage, health literacy, communication patterns, and social support.
CONCLUSION: This study identified the change trajectories and latent classes of lymphedema risk perception within 6 months after surgery in breast cancer patients and revealed the predictive effects of demographic, clinical, and psychosocial factors on these trajectories.
IMPLICATIONS FOR CANCER SURVIVORS: Breast cancer survivors should tailor their self-management strategies based on their BCRL risk perception trajectories. Those in the low-peaked group are advised to actively participate in lymphedema-related health education and enhance health literacy to improve risk awareness timely. The moderate-peaked group needs to reinforce knowledge and self-monitoring to maintain stable perception. The high-gradually declining group needs to maintain appropriate vigilance through regular self-monitoring and avoid risk perception fatigue. These suggestions are intended to provide risk perception trajectory-based stratified self-management support for patients, while further research is needed to determine their impact on long-term clinical outcomes.
OBJECTIVE: This study aimed to describe the level of lymphedema risk perception at discharge and to explore its change trajectories during the first 6 months after surgery in patients with breast cancer.
METHODS: Participants were recruited from two tertiary grade A hospitals in China and completed a baseline survey (questionnaires on demographic and clinical characteristics, lymphedema risk perception, health literacy, communication patterns, and perceived social support) and follow-up assessments (Lymphedema Risk Perception Questionnaire) at the 1st, 3rd, and 6th months postoperatively.
RESULTS: Among 225 patients completing baseline, 185 (82.3%) completed the 6-month follow-up. Risk perception showed moderate overall levels with an initial rise followed by decline. Three distinct trajectories emerged: high-gradually declining group, moderate-peaked group, and low-peaked group. Key predictors included education, health education exposure, treatment type, surgery, disease stage, health literacy, communication patterns, and social support.
CONCLUSION: This study identified the change trajectories and latent classes of lymphedema risk perception within 6 months after surgery in breast cancer patients and revealed the predictive effects of demographic, clinical, and psychosocial factors on these trajectories.
IMPLICATIONS FOR CANCER SURVIVORS: Breast cancer survivors should tailor their self-management strategies based on their BCRL risk perception trajectories. Those in the low-peaked group are advised to actively participate in lymphedema-related health education and enhance health literacy to improve risk awareness timely. The moderate-peaked group needs to reinforce knowledge and self-monitoring to maintain stable perception. The high-gradually declining group needs to maintain appropriate vigilance through regular self-monitoring and avoid risk perception fatigue. These suggestions are intended to provide risk perception trajectory-based stratified self-management support for patients, while further research is needed to determine their impact on long-term clinical outcomes.