PRESENTED BY
NURHAFIZAH BT ZAKARIA
2021228588
R ES EA R C H P R O P O S A L P R ES EN TA T I O N
T H E P R EV A LA N C E A N D R I S K FA C T O R S O F
LY M P H ED EM A A M O N G BR EA S T C A N C ER
PA T I EN T S I N M A LA Y S I A
We can describe the problemby asking
some questions,such as...
1.
Background of study
2. Literature Review
3. ProblemStatement
4. StudyObjective
5. Methdology
TA BLE O F C O N T EN T
6. DataAnalysis
BA C K G R O U N D
O F STUDY
Patients with breast cancer run the risk
of developing lymphedema,which
results in swollen arms or legs because
of a damaged lymphatic system.The
purpose of this research proposal is to
examine lymphedema prevalence and
risk factors in breast cancer patients.
We can create methods to prevent and
treat lymphedema in this population by
figuring out these risk factors.
LI T ER A T U R E R EV I EW
RISK FACTORS OF LYMPHEDEMA
EFFECT OF LYMPHEDEMA
Hand Function
Breast cancer patients with lymphedema have
Numerous research has looked into the risk factors for
lymphedema using data from the Iowa Women's Health
impaired hand function in comparison to those
Study and identified obesity, extensive axillary surgery, and
Patients with lymphedema reported limitations in
radiation therapy as key risk factors for lymphedema (Ahmed
et al.2011).
A high body mass index,major surgery,radiation therapy,and
chemotherapy were all noted as risk factors for lymphedema
in a study (Norman et al.,2009).
without lymphedema.(Box et al.2002)
activities requiring fine motor skills, such as writing,
buttoning,and manipulating small objects (Stout
Gergich et al.,2008).
Impairment
Breast cancer survivors with lymphedema
experienced reduced shoulder range of motion
compared to those without lymphedema(Ahmed
et al.2011).
Upper extremity lymphedema was associated with
decreased ROM in the affected arm(Stout Gergich
et al.2008).
LI T ER A T U R E R EV I EW
ASSESSMENT FOR
LYMPHEDEMA
EFFECT OF LYMPHEDEMA
The significance of a doctor's medical evaluation,
Hand Function
which frequently includes a comprehensive
Breast cancer patients with lymphedema have impaired hand function
clinical examination, the measurement of limb
in comparison to those without lymphedema. (Box et al.2002)
circumference,and a review of the patient's
Patients with lymphedema reported limitations in activities requiring
stated symptoms (Ahmed et al.2011).
fine motor skills, such as writing, buttoning, and manipulating small
objects (Stout Gergich et al.,2008).
Impairment
Breast cancer survivors with lymphedema experienced reduced
shoulder range of motion compared to those without
lymphedema(Ahmed et al.2011).
Upper extremity lymphedema was associated with decreased ROM in
the affected arm(Stout Gergich et al.2008).
Strength tests, such as grip and pinch strength
examinations,can assist measure muscle
function and spot lymphedema-related deficits
(McLaughlin et al.2008).
LI T ER A T U R E R EV I EW
PHYSIOTHERAPY
INTERVENTION
TREATMENT OF LYMPHEDEMA
Manual Lymphatic Drainage MLD,is a
Compression garments are frequently prescribed to offer external
specialized massage technique administered by
pressure and support to the afflicted limb, helping to reduce oedema
trained physiotherapists, and has been found to
and maintain enhanced lymphatic drainage (Stout Gergich et al.2008).
be effective in promoting lymphatic flow,
The medical care of lymphedema includes compression therapy as well
as the application of manual lymphatic drainage (MLD), a specialized
massage method carried out by licensed therapists (Ahmed et al.2011).
reducing swelling, and improving tissue drainage
(McLaughlin et al.,2008).
Improved lymphatic circulation, muscular
One such intervention is the use of diuretics to reduce fluid retention
strength,and joint mobility are some of the
(McLaughlin et al.2008)
advantages of exercise in the treatment of
lymphedema (Ahmed et al.2011).
S T U D Y O BJEC T I V E
The purposes of this study are:
a)
To determine the prevalence of lymphedema among
breast cancer patients.
b) To identify the risk factors associated with lymphedema
development in breast cancer patients.
c)
To examine lymphedema's impact on breast cancer
patients’ quality of life.
M ET H A D O L O G Y
Research
Design
Study setting
M ET H A D O L O G Y
A cross-sectional study to
investigate the relation
between the prevalence and
risk factors of lymphedema
among breast cancer patients in
Malaysia.
This study is based at the private
and government hospital in the
Klang Valley, National Cancer
Institution. This study involves the
patient that fulfils the inclusion
criteria from November 2023 until
February 2024
M ET H O D O L O G Y
Study design
Study Setting
Cross-sectional Study
Government, Private Hospitals in Klang Valley
Study Participant
Breast cancer patients that have lymphedema after getting their treatment
Sampling Procedure
Simple Random Sampling
Inclusion:
Female
Diagnose with breast cancer
Age between 30-80 years old
Normal BMI
Participants
Selection Criteria
Have concluded the treatment
Exclusion:
Male
Recurrent breast cancer
Cognitive dysfunction
History of neuropathic
History of lymphedema prior to breast cancer
Ethics Consideration / Approval
1.UITM
2.Government Hospitals
Private Hospitals
FLO W
C HA RT
Choose the best idea
as a solution
S A M P L E S IZ E
C A L C U L A T IO N
THE PROBLEM?
We need to decipher the problem we
are facing.Then we can solve problems
and quickly generate as many new
ideas as possible.
DA TA
A N A L Y S IS
Share your ideas.Discuss
all possible problemsolving ideas and solutions.
And write them all down.
G A N TT
C HA RT
Choose the best idea
as a solution
C O N C L U S IO N
Write down all the
conclusions obtained from
the vote and discussion.
R EFER EN C ES
Hayes, S. C., Janda, M., Cornish, B., Battistutta, D., & Newman, B. (2008). Lymphedema after breast cancer: Incidence, risk factors, and effect on upper body function. Journal
of Clinical Oncology, 26(21), 3536–3542. https://doi.org/10.1200/jco.2007.14.4899
DiSipio, T., Rye, S., Newman, B., & Hayes, S. (2013). Incidence of unilateral arm lymphoedema after breast cancer: A systematic review and meta-analysis. The Lancet
Oncology, 14(6), 500–515. https://doi.org/10.1016/s1470-2045(13)70076-7
Paskett, E. D., Dean, J. A., Oliveri, J. M., & Harrop, J. P. (2012). Cancer-related lymphedema risk factors, diagnosis, treatment, and impact: A Review. Journal of Clinical
Oncology, 30(30), 3726–3733. https://doi.org/10.1200/jco.2012.41.8574
Breast cancer - statpearls - NCBI bookshelf. (n.d.). https://www.ncbi.nlm.nih.gov/books/NBK482286/
Alkabban, F. M., & Ferguson, T. (2022, September 26). Breast cancer - statpearls - NCBI bookshelf. Breast Cancer. https://www.ncbi.nlm.nih.gov/books/NBK482286/
Gillespie, T. C., Sayegh, H. E., Brunelle, C. L., Daniell, K. M., & Taghian, A. G. (2018, August). Breast cancer-related lymphedema: Risk factors, precautionary measures, and
treatments. Gland surgery. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6107585/
McLaughlin, S. A., Wright, M. J., Morris, K. T., Giron, G. L., Sampson, M. R., Brockway, J. P., Hurley, K. E., Riedel, E. R., & Van Zee, K. J. (2008). Prevalence of lymphedema in
women with breast cancer 5 years after sentinel lymph node biopsy or axillary dissection: Objective measurements. Journal of Clinical Oncology, 26(32), 5213–5219.
https://doi.org/10.1200/jco.2008.16.3725
AR;, A. R. K. A. (2011, July 15). Risk factors for lymphedema in breast cancer survivors, the Iowa Women’s Health Study. Breast cancer research and treatment.
https://pubmed.ncbi.nlm.nih.gov/21761159/#:~:text=In%20the%20IWHS%2C%20obesity%2C%20poorer,arm%20symptoms%20in%20BC%20survivors.
Larsson, C., Ekvall Hansson, E., Sundquist, K., & Jakobsson, U. (2016). Kinesiophobia and its relation to pain characteristics and cognitive affective variables in older adults
with chronic pain. BMC Geriatrics, 16(1). https://doi.org/10.1186/s12877-016-0302-6
Stout Gergich, N. L., Pfalzer, L. A., McGarvey, C., Springer, B., Gerber, L. H., & Soballe, P. (2008). Preoperative assessment enables the early diagnosis and successful
treatment of lymphedema. Cancer, 112(12), 2809–2819. https://doi.org/10.1002/cncr.23494
McLaughlin, S. A., Wright, M. J., Morris, K. T., Giron, G. L., Sampson, M. R., Brockway, J. P., Hurley, K. E., Riedel, E. R., & Van Zee, K. J. (2008). Prevalence of lymphedema in
women with breast cancer 5 years after sentinel lymph node biopsy or axillary dissection: Objective measurements. Journal of Clinical Oncology, 26(32), 5213–5219.
https://doi.org/10.1200/jco.2008.16.3725