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Family Studies and Social Work, Miami University; Jane Armer is Professor, Sinclair School of Nursing, University of Missouri-Columbia and Director of Nursing Research, Ellis Fischel Cancer Center; Debbie Daunt is Assistant Professor of Nursing, Dominican University of California; Julie Dusold, BS, MS, and Scott Culbertson, MD, were research assistants with the lymphedema research project at the University of Missouri-Columbia (Armer, PI) at the time of these analyses Some two million breast cancer survivors in the USA are at risk of developing lymphoedema at some point during their lifetimes (Petrek et al, 2000; Bumpers et al, 2002). This condition involves the chronic and abnormal swelling of the arm, chest, breast and/or back that can occur following treatments for breast cancer that involve the removal of and/or damage to the lymph nodes located in the axilla (Passik and McDonald, 1998). Under-recognised and under-diagnosed, lymphoedema has a profound impact on functional health, psychosocial wellbeing, and family relationships (CasleySmith, 1992; Tobin et al, 1993; Passik and McDonald, 1998; Petrek et al, 2000; Radina and Armer, 2001, 2004; Radina and Watson, 2007; Thomas-MacLean et al, 2005). Long overlooked issues surrounding the survival of cancer are now being considered by healthcare research funding agencies and clinicians. Understanding the ways that people selfmanage the chronic symptoms of breast cancer treatment, such as lymphoedema, is essential to facilitate an improvement in the use of therapies and the quality of life of these people.
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