Latent profiles of adherence to lymphedema prevention behaviors and associated factors among breast cancer patients after surgery: a cross-sectional study

Abstract

Background Breast cancer-related lymphedema (BCRL) is a common complication after breast cancer surgery and can have lasting effects on physical function and quality of life. Prevention behaviors are an important component of BCRL risk reduction, yet patients do not necessarily engage in these behaviors in the same way. Previous studies have largely assessed adherence at the overall level, providing limited insight into differences in behavioral patterns among postoperative patients. A person-centered approach may therefore help identify distinct adherence profiles and provide a basis for targeted prevention and rehabilitation. Methods A cross-sectional study was conducted from July 2025 to March 2026 among 612 postoperative breast cancer patients recruited from the breast surgery outpatient clinic of a tertiary hospital in Zhengzhou, China, using convenience sampling. Participants completed the Adherence to Lymphedema Prevention Behaviors Scale for Breast Cancer Survivors, the Multidimensional Assessment of Interoceptive Awareness, Version 2 (MAIA-2), the Self-Regulatory Fatigue Scale (SRF-S), and a general information questionnaire. Latent profile analysis (LPA) was used to identify distinct adherence profiles, followed by multinomial logistic regression to examine factors associated with profile membership. Results Latent profile analysis identified three distinct profiles of adherence to lymphedema prevention behaviors among postoperative breast cancer patients: global low-adherence profile (n = 82, 13.4%), the moderate adherence with skin-care deficit profile (n = 110, 18.0%), and the active prevention profile (n = 420, 68.6%). Multinomial logistic regression analysis showed that age, tumor stage, history of chemotherapy or radiotherapy, self-regulatory fatigue, and interoceptive sensitivity were significant factors associated with latent profile membership (p < 0.05). Conclusion Adherence to lymphedema prevention behaviors showed substantial heterogeneity among postoperative breast cancer patients. Dynamic assessment of adherence should be incorporated into clinical care, with stratified management and individualized interventions tailored to the behavioral characteristics of different profiles. Particular attention should be given to patients with lower adherence to strengthen prevention behaviors and support postoperative rehabilitation.