Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2025
Pain and lymphedema characteristics of women with breast cancer-related lymphedema with and without type 2 diabetes mellitus.
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Uzelpasaci Esra, Kemer Aysel Ozge, Ozün Ozgu Inal, Yaman Aysegül
Аннотация
AIM: This study aimed to compare the pain and lymphedema characteristics of women with breast cancer-related lymphedema (BCRL) with and without type 2 diabetes mellitus (T2DM).
METHODS: A case-control study was conducted with 105 breast cancer survivors diagnosed with unilateral BCRL, divided into T2DM (n = 51) and non-T2DM (n = 54) groups. For pain characteristics, Visual Analog Scale (VAS) and Self-administered Leeds Assessment of Neuropathic Symptoms and Signs (S-LANSS) were used. In addition, circumference measurement, the Lymphedema Life Impact Scale (LLIS), and Lymphedema Quality of Life Questionnaire (LYMQOL) were applied to determine the severity of lymphedema and its impact on quality of life. Statistical analysis was performed using t-tests, Mann-Whitney U tests, and Chi-square tests.
RESULTS: T2DM patients exhibited significantly higher pain intensity (VAS) (p < 0.001, t = ‒ 4.148), neuropathic symptoms (S-LANSS ≥ 12 in 72.5% vs. 18.5%) (p < 0.001, t = ‒ 6.435), and poorer quality of life metrics (LLIS-physical concerns, LLIS-psychococial concerns, LYMQOL-function, LYMQOL-appearance, LYMQOL-symptoms, LYMQOL-mood, LYMQOL-total) compared to the non-T2DM group (p1 < 0.001, t1 = ‒ 3.661; p2 = 0.016, t2 = ‒ 2.461; p3 = 0.004, t3 = ‒ 2.963; p4 < 0.001, z = ‒ 3.483; p5 < 0.001, t5 = ‒ 3.891; p6 = 0.018, t6 = ‒ 2.396; p7 = 0.001, t7 = ‒ 3.544). Lymphedema severity (p < 0.001), volume (p < 0.001, z = ‒ 3.716) and duration (p < 0.001, z = ‒ 3.716) were also significantly higher in the T2DM group. Despite these differences, the place of onset of lymphedema, LLIS functional concerns and LYMQOL 21st question (How much lymphedema affects overall quality of life on a scale from 0: not at all to 10: a great deal) were similar in both groups (p > 0.05).
CONCLUSION: T2DM significantly amplifies pain and worsens lymphedema-related outcomes in BCRL patients, underscoring the need for targeted, multidisciplinary interventions that address metabolic, physical, and psychosocial factors. Although lymphedema severity, duration, and volume were significantly higher in the T2DM group, these factors may have also contributed to the reduced functional status and quality of life outcomes independently of T2DM. Future research should explore the long-term relationship between T2DM, pain, and lymphedema to develop comprehensive care strategies for this population.
METHODS: A case-control study was conducted with 105 breast cancer survivors diagnosed with unilateral BCRL, divided into T2DM (n = 51) and non-T2DM (n = 54) groups. For pain characteristics, Visual Analog Scale (VAS) and Self-administered Leeds Assessment of Neuropathic Symptoms and Signs (S-LANSS) were used. In addition, circumference measurement, the Lymphedema Life Impact Scale (LLIS), and Lymphedema Quality of Life Questionnaire (LYMQOL) were applied to determine the severity of lymphedema and its impact on quality of life. Statistical analysis was performed using t-tests, Mann-Whitney U tests, and Chi-square tests.
RESULTS: T2DM patients exhibited significantly higher pain intensity (VAS) (p < 0.001, t = ‒ 4.148), neuropathic symptoms (S-LANSS ≥ 12 in 72.5% vs. 18.5%) (p < 0.001, t = ‒ 6.435), and poorer quality of life metrics (LLIS-physical concerns, LLIS-psychococial concerns, LYMQOL-function, LYMQOL-appearance, LYMQOL-symptoms, LYMQOL-mood, LYMQOL-total) compared to the non-T2DM group (p1 < 0.001, t1 = ‒ 3.661; p2 = 0.016, t2 = ‒ 2.461; p3 = 0.004, t3 = ‒ 2.963; p4 < 0.001, z = ‒ 3.483; p5 < 0.001, t5 = ‒ 3.891; p6 = 0.018, t6 = ‒ 2.396; p7 = 0.001, t7 = ‒ 3.544). Lymphedema severity (p < 0.001), volume (p < 0.001, z = ‒ 3.716) and duration (p < 0.001, z = ‒ 3.716) were also significantly higher in the T2DM group. Despite these differences, the place of onset of lymphedema, LLIS functional concerns and LYMQOL 21st question (How much lymphedema affects overall quality of life on a scale from 0: not at all to 10: a great deal) were similar in both groups (p > 0.05).
CONCLUSION: T2DM significantly amplifies pain and worsens lymphedema-related outcomes in BCRL patients, underscoring the need for targeted, multidisciplinary interventions that address metabolic, physical, and psychosocial factors. Although lymphedema severity, duration, and volume were significantly higher in the T2DM group, these factors may have also contributed to the reduced functional status and quality of life outcomes independently of T2DM. Future research should explore the long-term relationship between T2DM, pain, and lymphedema to develop comprehensive care strategies for this population.