A Comparison of Four Diagnostic Criteria for Lymphedema in a Post-Breast Cancer Population

Armer, Jane M.; Stewart, Bob R.

doi:10.1089/lrb.2005.3.208

Cited by 295 publications

(270 citation statements)

References 22 publications

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“…Estimates of BCRL incidence and prevalence vary consider-ably in the literature due to a lack of standardised diagnostic criteria and measurement procedures, 13,14 limitations imposed by study designs along with variations in study populations and follow-up duration. 14,15 Studies have variously reported evaluation methods including selfreport of symptoms (e.g.…”

Section: Breast Cancer-related Lymphoedemamentioning

confidence: 99%

Breast cancer-related lymphoedema risk reduction advice: A challenge for health professionals

Nielsen

Gordon

Selby

2008

Cancer Treatment Reviews

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SummaryBreast cancer-related lymphoedema (BCRL) is a debilitating, distressing condition affecting approximately one in five breast cancer survivors (Clark B, Sitzia J, Harlow W. Incidence and risk of arm oedema following treatment for breast cancer: a three-year follow-up study. QJM 2005;98:343-8). The evidence-base for breast cancer-related lymphoedema risk reduction advice is scant and contradictory, with most studies in the area limited by small numbers, retrospective design and other methodological inadequacies. Current advice has the capacity to profoundly alter quality of life following treatment for breast cancer. Health professionals should review the risk reduction advice they provide to reflect the current understanding of aetiology and risk factors. Further research is required to provide more evidence for the content, to identify optimal methods of precautionary education delivery and to determine the effect of the advice on the patient's quality of life and perception of recovery.

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Section: Breast Cancer-related Lymphoedemamentioning

confidence: 99%

Breast cancer-related lymphoedema risk reduction advice: A challenge for health professionals

Nielsen

Gordon

Selby

2008

Cancer Treatment Reviews

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“…For example, the 50% incidence of chemotherapy-induced peripheral neuropathy is specifically associated with the agent paclitaxel (18). Published estimates of lymphedema incidence range from 3% for women who undergo sentinel lymph node biopsy and no radiation (20) to 70% in women who undergo axillary dissection (21). To our knowledge, however, there are no studies that account for overlapping treatment sequelae to provide an overall estimate of the proportion of breast cancer survivors who experience at least one of the aforementioned sequelae during the first or second year after diagnosis.…”

mentioning

confidence: 99%

Exercise for Secondary Prevention of Breast Cancer: Moving from Evidence to Changing Clinical Practice

Schmitz

2011

Cancer Prevention Research

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Relating to the report of Irwin and colleagues in this issue of the journal (beginning on page 522), this perspective discusses exercise training interventions as secondary prevention in breast cancer survivors. Burgeoning observational evidence indicates that prescribing aerobic exercise of 3 hours or more per week could have meaningful mortality and morbidity benefits for breast cancer survivors. Adherence to this exercise prescription, however, will require an infrastructure to guide survivors and to address the common clinical treatment sequelae that might interfere with survivors' ability to regularly perform this level of activity (e.g., symptoms related to estrogen deprivation, arthralgias due to aromatase inhibitors, fatigue, lymphedema, chemotherapy-induced peripheral neuropathy, osteoporosis, upper-extremity functional impairments, and overall functional decline). On the basis of cardiac rehabilitation, a model is proposed to integrate exercise prescription into breast cancer survivor clinical care, with referral to community-based programs for most women. Cancer Prev Res; 4(4); 476-80. Ó2011 AACR.The article by Irwin and colleagues appearing elsewhere in this issue of the journal (1) adds to prior strong prospective observational studies demonstrating decreased overall and disease-specific mortality among more versus less physically active breast cancer survivors. A 2010 meta-analysis included 6 prior studies on this topic (2). As with the study of Irwin and colleagues, the meta-analysis analyzed distinct effects of physical activity measured pre-versus postdiagnosis. The meta-analysis summary estimates of the reduction of breast cancer-specific and all-cause mortality for the women who self-reported the most compared to the least pre-diagnosis physical activity were 7% and 18%, respectively. These estimates were based on pooled data from 2 studies each for breast cancer-specific (3, 4) and allcause mortality (3, 5). Irwin and colleagues reported reductions of 29% for breast cancer-specific and 39% for overall mortality among the most-versus least-active women prediagnosis.Unfortunately, physical activity levels decline after diagnosis (6) and functional status remains lower among a substantial minority of breast cancer survivors for over 5 years after diagnosis (7,8). These issues make it difficult to conclude that data on prediagnosis physical activity are relevant for examining the mortality benefit of exercise in survivors. In short, the women who are active before diagnosis may not be able to be active after diagnosis. Therefore, it is of interest to understand whether physical activity after diagnosis confers benefits. In the 2010 metaanalysis, summary estimates based on pooled effects from 4 studies (3, 9-11) showed that breast cancer-specific mortality was reduced 34% and all-cause mortality was reduced 41% for the women who reported being most versus least active postdiagnosis. Irwin and colleagues observed mortality reductions of 39% (breast cancer-specific) and 46% (overall) among w...

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“…Traditionally, lymphedema has been clinically diagnosed by healthcare professionals' observations of swelling, and has often arbitrarily been defined in research as a 2-cm increase in limb girth, a 200-mL or more increase in limb volume, or a 5% or greater limb volume change Cormier et al, 2009;Stout et al, 2008). Inconsistency in the criteria defining lymphedema and the use of different measures has posed tremendous difficulty in accurately diagnosing lymphedema (Armer & Stewart, 2005). Additional contributing factors to the challenge include failure to precisely evaluate symptoms related to lymphedema, co-existing conditions, insufficient knowledge and lack of awareness among healthcare professionals.…”

Section: Diagnosis Of Breast Cancer-related Lymphedemamentioning

confidence: 99%

“…In addition, experience of symptoms has elicited tremendous distress in breast cancer survivors and exerted negative impact on their quality of lives (Fu & Rosedale 2009;Pyszel et al, 2006). Symptoms should be one of the major patient-centered clinical outcomes for evaluating the effectiveness of lymphedema treatment (Armer et al, 2005;Sitzia, Stanton, & Badger, 1997). A symptom checklist ( Physical examination and symptom assessment can also help to differentiate if the onset of lymphedema following breast cancer treatment is gradual or sudden (Fu et al, 2009).…”

Section: Health History and Physical Examinationmentioning

confidence: 99%

Preparing for and Coping with Breast Cancer-Related Lymphedema

Radina¹,

Fu²

2012

Novel Strategies in Lymphedema

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Lymphedema is a swelling caused by the abnormal accumulation of lymphatic fluid in the skin. Lymphedema can be caused by burns, injury, surgery, radiation therapy or cancer treatment that cancer survivors undergo. Risk of developing lymphedema is high especially in those with breast or prostate cancer. It is hereditary and can appear without warning at any time of life and is related to obesity and circulatory problems. If not treated, lymphedema can be painful and lead to life-threatening infections. This book will help physicians who deal with lymphedema. It will help you understand how the lymphatic system works, how lymphedema is diagnosed, how to cope with the challenges of lymphedema, how to find treatment, and how to deal with insurance issues.Novel Strategies in Lymphedema is for those with, or at risk of, developing lymphedema, and the healthcare professionals who care for them.

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A Comparison of Four Diagnostic Criteria for Lymphedema in a Post-Breast Cancer Population

Cited by 295 publications

References 22 publications

Breast cancer-related lymphoedema risk reduction advice: A challenge for health professionals

Breast cancer-related lymphoedema risk reduction advice: A challenge for health professionals

Exercise for Secondary Prevention of Breast Cancer: Moving from Evidence to Changing Clinical Practice

Preparing for and Coping with Breast Cancer-Related Lymphedema

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