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Fu MR, Axelrod D, Cleland CM, et al. Symptom report in detecting breast cancer-related lymphedema. Breast Cancer (Dove Med Press). 2015;7:345-52doi: 10.2147/BCTT.S87854.
Fu, M. R., Axelrod, D., Cleland, C. M., Qiu, Z., Guth, A. A., Kleinman, R., Scagliola, J., & Haber, J. (2015). Symptom report in detecting breast cancer-related lymphedema. Breast cancer (Dove Medical Press), 7345-52. https://doi.org/10.2147/BCTT.S87854
Fu, Mei R, et al. "Symptom report in detecting breast cancer-related lymphedema." Breast cancer (Dove Medical Press) vol. 7 (2015): 345-52. doi: https://doi.org/10.2147/BCTT.S87854
Fu MR, Axelrod D, Cleland CM, Qiu Z, Guth AA, Kleinman R, Scagliola J, Haber J. Symptom report in detecting breast cancer-related lymphedema. Breast Cancer (Dove Med Press). 2015 Oct 15;7:345-52. doi: 10.2147/BCTT.S87854. eCollection 2015. PMID: 26527899; PMCID: PMC4621182.
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Breast Cancer (Dove Med Press). 2015 Oct 15;7:345-52. doi: 10.2147/BCTT.S87854. eCollection 2015.

Symptom report in detecting breast cancer-related lymphedema.

Breast cancer (Dove Medical Press)

Mei R Fu, Deborah Axelrod, Charles M Cleland, Zeyuan Qiu, Amber A Guth, Robin Kleinman, Joan Scagliola, Judith Haber

Affiliations

  1. College of Nursing, New York University, New York, NY, USA.
  2. Department of Surgery, NYU School of Medicine, New York, NY, USA ; NYU Clinical Cancer Center, New York, NY, USA.
  3. Department of Chemistry and Environmental Science, New Jersey Institute of Technology, Newark, NJ, USA.
  4. Department of Surgery, NYU School of Medicine, New York, NY, USA.

PMID: 26527899 PMCID: PMC4621182 DOI: 10.2147/BCTT.S87854

Abstract

Breast cancer-related lymphedema is a syndrome of abnormal swelling coupled with multiple symptoms resulting from obstruction or disruption of the lymphatic system associated with cancer treatment. Research has demonstrated that with increased number of symptoms reported, breast cancer survivors' limb volume increased. Lymphedema symptoms in the affected limb may indicate a latent stage of lymphedema in which changes cannot be detected by objective measures. The latent stage of lymphedema may exist months or years before overt swelling occurs. Symptom report may play an important role in detecting lymphedema in clinical practice. The purposes of this study were to: 1) examine the validity, sensitivity, and specificity of symptoms for detecting breast cancer-related lymphedema and 2) determine the best clinical cutoff point for the count of symptoms that maximized the sum of sensitivity and specificity. Data were collected from 250 women, including healthy female adults, breast cancer survivors with lymphedema, and those at risk for lymphedema. Lymphedema symptoms were assessed using a reliable and valid instrument. Validity, sensitivity, and specificity were evaluated using logistic regression, analysis of variance, and areas under receiver operating characteristic curves. Count of lymphedema symptoms was able to differentiate healthy adults from breast cancer survivors with lymphedema and those at risk for lymphedema. A diagnostic cutoff of three symptoms discriminated breast cancer survivors with lymphedema from healthy women with a sensitivity of 94% and a specificity of 97% (area under the curve =0.98). A diagnostic cutoff of nine symptoms discriminated at-risk survivors from survivors with lymphedema with a sensitivity of 64% and a specificity of 80% (area under the curve =0.72). In the absence of objective measurements capable of detecting latent stages of lymphedema, count of symptoms may be a cost-effective initial screening tool for detecting lymphedema.

Keywords: heaviness; pain; risk; screening; sensitivity; swelling

References

  1. Lymphology. 2009 Dec;42(4):161-75 - PubMed
  2. Ann Surg Oncol. 2010 Jul;17(7):1847-53 - PubMed
  3. J Clin Oncol. 2008 Nov 10;26(32):5213-9 - PubMed
  4. Semin Oncol Nurs. 2013 Feb;29(1):50-60 - PubMed
  5. Breast Cancer Res Treat. 2006 Feb;95(3):279-93 - PubMed
  6. Eur J Oncol Nurs. 2016 Feb;20:10-6 - PubMed
  7. Nurs Res. 2003 Nov-Dec;52(6):370-9 - PubMed
  8. Arch Phys Med Rehabil. 2011 Apr;92(4):603-10 - PubMed
  9. Ann Surg Oncol. 2014 Oct;21(11):3481-9 - PubMed
  10. Am J Epidemiol. 2006 Apr 1;163(7):670-5 - PubMed
  11. Cancer. 1950 Jan;3(1):32-5 - PubMed
  12. Lymphology. 2003 Jun;36(2):84-91 - PubMed
  13. J Pain Symptom Manage. 2009 Dec;38(6):849-59 - PubMed
  14. Cancer Epidemiol Biomarkers Prev. 2007 Apr;16(4):775-82 - PubMed
  15. Psychooncology. 2013 Jul;22(7):1466-84 - PubMed
  16. Psychooncology. 2010 Mar;19(3):299-305 - PubMed
  17. J Am Coll Surg. 2013 Mar;216(3):380-9; quiz 511-3 - PubMed

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