Health literacy varies widely among women after breast cancer surgery, study finds

Women who have undergone breast cancer surgery show wide variation in health literacy, and that variation is linked to age and educational attainment, according to a cross-sectional study published in Supportive Care in Cancer. The research, led by Sefa Gümrük Aslan and colleagues, set out to evaluate health literacy and its associations with demographic, clinical, functional, and psychosocial characteristics in women at risk for lymphedema following breast cancer surgery.

The study included 59 women who had undergone unilateral breast cancer surgery. Researchers assessed health literacy using the Turkish Health Literacy Scale-32 (TSOY-32) and evaluated lymphedema-related quality of life with the LYMQOL-Arm questionnaire. Participants were classified according to lymphedema stage, and the team carried out between-stage comparisons, correlation analyses, and an exploratory ordinal logistic regression.

The participants had a mean age of 55.71 years, with a standard deviation of 12.09 years. Health literacy was classified as inadequate in 11.9 percent of the women, problematic or limited in 27.1 percent, sufficient in 33.9 percent, and excellent in 27.1 percent.

Lymphedema stage was associated with differences in the LYMQOL-Arm appearance domain (p = 0.045) and the function domain (p = 0.046), although post hoc comparisons for the function domain did not identify significant pairwise differences. Neither marital status nor occupation was significantly associated with lymphedema stage according to the Fisher–Freeman–Halton exact test (p = 0.372 and p = 0.761, respectively).

The exploratory regression analysis identified two demographic factors associated with health literacy levels. Older age was associated with lower odds of higher health literacy (OR = 0.916, 95% CI 0.870–0.964; p < 0.001), whereas higher educational attainment was associated with greater odds (OR = 1.498, 95% CI 1.011–2.217; p = 0.044). The authors note that the regression was exploratory in nature, and the small sample size of 59 women limits the strength of the conclusions that can be drawn.

The study’s authors conclude that health literacy varied considerably among women following breast cancer surgery and was associated with age and educational attainment. They also report that functional and psychosocial quality-of-life domains were interrelated, while some differences were observed across lymphedema stages. The findings, they suggest, support further investigation of health-literacy-sensitive educational and self-management approaches in breast cancer-related lymphedema care.

Because the study was cross-sectional, it captures a single point in time and cannot establish causal relationships between health literacy and quality-of-life outcomes. The authors frame the work as a basis for further research rather than as evidence for the effectiveness of any particular intervention. The abstract notes that health literacy may influence individuals’ understanding of lymphedema, engagement in self-management, and perceived quality of life following breast cancer surgery, but the study itself was designed to evaluate associations rather than to test an educational program.

Subject of Research: Health literacy and its associations with demographic, functional, and psychosocial outcomes in women at risk for lymphedema after breast cancer surgery

Article Title: Health literacy as a determinant of psychosocial and functional outcomes in individuals at risk for lymphedema

Article References: Aslan, S. G., İnan, H. A., Köylü, S. U., & Mandıroğlu, S. (2026). Health literacy as a determinant of psychosocial and functional outcomes in individuals at risk for lymphedema. Supportive Care in Cancer, 34(11), Article 1137. https://doi.org/10.1007/s00520-026-11395-2

Image Credits: AI Generated

DOI: 10.1007/s00520-026-11395-2

Keywords: health literacy, breast cancer, lymphedema, quality of life, LYMQOL-Arm, TSOY-32, cross-sectional study, self-management, psychosocial outcomes, educational attainment, supportive care, Health