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