Scholars@Duke publication: Examining the Interrelationships of Lymphedema with Pain, Physical Function, and Demographic and Medical Variables in Women with Breast Cancer and Pain.

Examining the Interrelationships of Lymphedema with Pain, Physical Function, and Demographic and Medical Variables in Women with Breast Cancer and Pain.

Publication , Journal Article

Amaden, GH; Hyland, KA; Winger, JG; Kelleher, SA; Diachina, AK; Miller, SN; Westbrook, K; Kimmick, G; Sutton, L; Fu, MR; Somers, TJ

Published in: Clin Breast Cancer

July 9, 2025

Published version (DOI) Link to item

PURPOSE: To examine the relationship of lymphedema with pain, physical function, and demographic and medical variables in women with breast cancer and pain. METHODS: Secondary analysis of baseline data from a study of women with breast cancer and pain. Self-report questionnaires assessed lymphedema, pain severity, pain medication use behavior, pain-related cognitions (ie, pain self-efficacy, pain catastrophizing), and physical function (ie, basic and intermediate activities of daily living (ADLs)). Demographic and medical variables were extracted from the medical record. Univariate analyses examined relationships among lymphedema and variables of interest. RESULTS: Women (N = 347, Mage = 57 years, 63% White) reported moderate pain severity (M = 4.04). Twenty-six percent of women (n = 85) reported having lymphedema. Women with lymphedema endorsed greater pain severity (P = .007) and pain catastrophizing (P = .015) than women without lymphedema; groups did not differ on pain medication use or pain self-efficacy. Women with lymphedema reported a reduced capacity to complete intermediate ADLs compared to women without lymphedema (P = .044); groups did not differ on ability to complete basic ADLs. Women with lymphedema were more likely to be non-White, have lower educational attainment, have undergone lymph node removal or dissection, and received radiation therapy. CONCLUSION: In women with breast cancer and moderate pain, lymphedema is associated with greater pain severity and pain catastrophizing, and decreased ability to complete intermediate ADLs. Women with lymphedema and pain may benefit from tailored, accessible cognitive-behavioral-physiological interventions to improve self-management (eg, Pain Coping Skills Training, interventions to promote lymph flow and reduce inflammation). Disparities in lymphedema prevalence by race and education warrant further exploration.