Cancer-related impairments degrade survivors’ quality of life, independence, and societal integration, yet may be ameliorated, or even reversed, with effective care. Unfortunately, few patients receive care for their impairments. The impact of this neglect remains under-researched and its impact on healthcare (HC) utilization is unknown.

To delineate the magnitude and patterns of HC utilization between breast cancer (BC) survivors with and without one of its most common, remediable and functionally limiting sequelae; upper extremity lymphedema.

We conducted a population-based, retrospective longitudinal cohort study of Olmsted County, MN residents who were newly diagnosed with BC in the 21 year period beginning on January 1, 1990 and concluding December 31, 2010. HC utilization was characterized using the Berenson–Eggers Type of Service (BETOS) categories.

Overall HC utilization as well as its compartmentalization into the BETOS categories of: (1) evaluation and management, (2) procedures, (3) imaging, (4) tests, (5) durable medical equipment, (6) physical/occupational therapy, (7) other, and (8) exceptions/unclassified.

The cohort included 1906 subjects of which 94% (1800) had records meeting the inclusion criteria. Mean follow-up per survivor was 8.8 years (median, 8, range 1–23 years); 1239 were living and residing in Olmsted County at the study's conclusion. Analysis revealed that:

–survivors with BC-associated lymphedema used>30% more services annually than their unaffected counterparts;

their increased utilization lessened but persisted for at least 10 years after diagnosis;

this finding of increased utilization is robust, extending across all BETOS categories, and is further amplified as BMI increases.

An analysis of BC-related lymphedema as an exemplar of cancer impairment-associated HC utilization revealed that this often remediable condition is associated with a significant,>30%, increase in HC utilization that extends for a prolonged period.