Table 3.

Cross‐sectional studies

Subjects	Methods	Measures	Results	Conclusions	Country and year	Reference
50 female patients with breast cancer‐ related arm swelling.	Cross‐sectional study comparing patients with breast cancer‐ related arm swelling with controls with breast cancer but without swelling matched for age, duration since treatment and type of treatment.	Modified Karnofski Performance Scale, CIS, SSSI, HAD and PAIS administered at one time point.	Modified Karnofski Scale indicated considerable functional impairment in patients with arm swelling; CIS indicated patients with arm swelling experienced greater psychiatric morbidity. SSSI showed no significant difference in concomitant life stressors. No significant differences in HAD scores between groups. Significant differences in five of seven domains of the PAIS.	Patients with breast cancer‐ related arm swelling experience greater functional impairment, poorer psychosocial adjustment to their illness and anxiety and depression resulting in considerable difficulty with the domestic and social environment and relationships within the family.	UK 1993	(23)
151 women surgically treated for early stage breast cancer.	Cross‐sectional study comparing women with ALND and radiation and women with mastectomy without radiation controlled for demography, surgical factors and treatment types.	FACT‐B administered at one time point.	Lymphoedema occurred in 27·8% of women. Similar lymphoedema rates in both types of surgery. Women with lymphoedema in both surgical groups scored significantly lower in four of five subsections of the FACT‐B than women without lymphoedema.	Lymphoedema occurs at appreciable rates and its impact on long‐term quality of life in survivors with early stage breast cancer should not be underestimated.	USA 2002	(24)
23 patients with lymphoedema of upper and lower limbs.	Cross‐sectional study comparing QoL of patients with and without lymphoedema.	SF‐36 administered at one time point.	QoL of patients with lymphoedema was significantly reduced in both physical and mental health domains as well as social interaction.	QoL of patients with lymphoedema is poorer than in patients without lymphoedema particularly in ability to function physically, mentally and socially.	Brazil 2002	(25)
228 with chronic oedema of all causes.	Cross‐sectional study comparing patients with published normative data. (mean age 71·4 years)	SF36 administered at one time point. McGill short form pain assessment tool.	Significant differences in role physical, role emotional, social functioning and physical functioning (P≤0·001). 50% of patients suffered pain or discomfort.	Indications of poorer HRQoL in patients with lymphoedema compared with normative controls with particular emphasis on their ability to function physically and socially and the emotional consequences of the condition.	UK 2003	(5)

CIS, Clinical Interview Schedule; FACT‐B, Functional Assessment of Cancer Therapy‐Breast; HAD, Hospital Anxiety and Depression Scale; PAIS, Psychological Adjustment to Illness Scale; SF‐36, Medical Outcomes Study – Short Form; SSSI, Social Stress and Support Inventory.