Development and clinimetric properties of the Dutch Breast Edema Questionnaire (BrEQ-Dutch version) to diagnose the presence of breast edema in breast cancer patients

Verbelen, Hanne; Vrieze, Tessa De; Soom, Timia Van; Meirte, Jill; Goethem, M. Van; Hufkens, Godelieve; Tjalma, Wiebren A.A.; Gebruers, Nick

doi:10.1007/s11136-019-02337-z

Cited by 6 publications

(12 citation statements)

References 27 publications

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“…In order to relate our objective findings with the patients' perceptions, we selected BREAST-Q questions corresponding to breast oedema-related symptoms. Pain, heaviness, swelling and tensed skin in the breast have previously been reported in the literature [5,6,26]. The patients in this study did not report any breast oedema-related symptoms pre-or postoperatively, as indicated by the median BREAST-Q responses ranging from 1 to 2.…”

Section: Discussionsupporting

confidence: 46%

“…Fortunately, a patient-reported questionnaire for breast oedema was recently presented and validated in a study by Verbelen et al [26]. The questionnaire focuses on patients following BCS, similar to most studies published on breast oedema [5,6,26]. A breast oedemaspecific questionnaire may be useful in future studies for assessing breasts following both breast reconstruction and BCS.…”

Section: Discussionmentioning

confidence: 99%

“…The questions we selected have not been validated for breast oedema assessment. Fortunately, a patient-reported questionnaire for breast oedema was recently presented and validated in a study by Verbelen et al [26]. The questionnaire focuses on patients following BCS, similar to most studies published on breast oedema [5,6,26].…”

Section: Discussionmentioning

confidence: 99%

“…In the presence of such a threshold, TDC measurements could be performed to assess breast oedema routinely at an out-patient clinic. Moreover, a translation of the Dutch breast oedema questionnaire could enable the use of a validated patient-reported diagnostic tool [26].…”

Section: Discussionmentioning

confidence: 99%

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Assessment of local tissue water in breasts following breast reconstruction with an expander prosthesis or DIEP flap

Tallroth

Brorson

Mobargha

et al. 2021

Journal of Plastic Surgery and Hand Surgery

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The role of breast oedema in breast reconstruction is unknown. Therefore, our aim was to investigate local tissue water (LTW) and breast oedema-related symptoms in breasts reconstructed with either an expander prosthesis (EP) or with a deep inferior epigastric perforator (DIEP) flap at a minimum of one year postoperatively. Sixty-eight patients randomised to breast reconstruction with an EP or DIEP flap completed follow-up. Objective evaluation was performed at a mean of 25 (standard deviation, SD 9.5) months following breast reconstruction, and included measurements of breast volume and LTW with the MoistureMeterDV R instrument. The patients completed the BREAST-Q questionnaire pre-and postoperatively. No significant differences in LTW were found when comparing EP and DIEP flap reconstructed breasts. The reconstructed breasts had an increase in LTW compared with the non-operated contralateral breasts. The BREAST-Q responses related to breast oedema symptoms were overall low and the median responses ranged from 1 to 2. A score of 1 indicated that symptoms were experienced 'None of the time'. Our findings indicate that mastectomy followed by breast reconstruction inflicts damage on the lymphatic system, shown as an increase in LTW. However, no breast oedema-related symptoms were reported in the BREAST-Q questionnaire, and therefore, we consider our objective results to be below a potential threshold for symptomatic breast oedema. A threshold for clinical indication of breast oedema remains to be defined.

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Section: Discussionsupporting

confidence: 46%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Assessment of local tissue water in breasts following breast reconstruction with an expander prosthesis or DIEP flap

Tallroth

Brorson

Mobargha

et al. 2021

Journal of Plastic Surgery and Hand Surgery

View full text Add to dashboard Cite

show abstract

“…Although there are challenges with capturing physical changes associated with breast oedema, validated and reliable patient-reported outcomes are available, including a recently published breast oedema questionnaire [13][14][15]33]. Both the EORTC-Breast questionnaire and LSIDS captured the symptoms and severity of breast symptoms experienced by women and demonstrated significant reduction in symptoms.…”

Section: Discussionmentioning

confidence: 99%

Reduction of breast lymphoedema secondary to breast cancer: a randomised controlled exercise trial

Kilbreath

Ward

Davis

et al. 2020

Breast Cancer Res Treat

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Background Breast lymphoedema can occur following surgical treatment for breast cancer. We investigated whether an exercise program reduced breast lymphoedema symptoms compared to a non-exercise control group. Methods A single-blinded randomised controlled trial was conducted in which women with stable breast lymphoedema (n = 89) were randomised into an exercise (n = 41) or control (n = 47) group. The intervention comprised a 12-week combined aerobic and resistance training program, supervised weekly by an accredited exercise physiologist. All participants completed a weekly symptoms diary and were assessed monthly to ensure that there was no exacerbation of their lymphoedema. Changes in the breast were captured physically with ultrasound and bioimpedance spectroscopy and changes in symptoms were captured using European Organization for Research and Treatment of Cancer (EORTC) Breast Cancer (BR23) and Lymphoedema Symptom Intensity and Distress questionnaires. Results The exercise group reported a greater reduction in breast-related symptoms than the control group, assessed by the EORTC BR23 breast symptom questions. Measures of extracellular fluid, assessed with bioimpedance spectroscopy ratio, decreased in the exercise group compared to the control group. No significant difference was detected in dermal thickness in the breast, assessed by ultrasound. Session attendance in the exercise sessions was high, with two musculoskeletal adverse events reported, but no exacerbations of lymphoedema observed. Conclusion Combined resistance and aerobic exercise training is safe for women living with breast lymphoedema. Preliminary data suggest exercise training can reduce breast lymphoedema symptoms to a greater extent than usual care.

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Quantification of breast lymphoedema following conservative breast cancer treatment: a systematic review

et al. 2022

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Purpose Breast lymphoedema is a possible side effect of breast conserving surgery, but it is poorly understood. This is due, in part, to difficulty assessing the breast. This systematic review described outcome measures that quantify breast lymphoedema signs and symptoms and evaluated the measurement properties for these outcome measures. Method Seven databases were searched using terms in four categories: breast cancer, lymphoedema and oedema, clinician reported (ClinROM) and patient reported outcome measures (PROM) and psychometric and measurement properties. Two reviewers independently reviewed studies and completed quality assessments. The Consensus-based Standards for the Selection of Health Measurement Instruments (COSMIN) methodology was used for studies including measurement property evidence. Results Fifty-six papers were included with thirteen questionnaires, eight patient-reported rating scales, seven physical measures, seven clinician-rating scales and four imaging techniques used to quantify breast lymphoedema. Based on COSMIN methodology, one ClinROM had sufficient reliability, ultrasound measuring dermal thickness. Tissue dielectric constant (TDC) measuring local tissue water had promising reliability. Four questionnaires had sufficient content validity (BLYSS, BLSQ, BrEQ and LYMQOL-Breast). Conclusions Ultrasound is recommended to reliably assess breast lymphoedema signs. No PROM can be recommended with confidence, but BLYSS, BLSQ, BrEQ and LYMQOL-Breast are promising. Further research is recommended to improve evidence of measurement properties for outcome measures. Implications for Cancer Survivors There are many approaches to assess breast lymphoedema, but currently, only ultrasound can be recommended for use, with others, such as TDC and questionnaires, showing promise. Further research is required for all approaches to improve evidence of measurement properties.

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Development and clinimetric properties of the Dutch Breast Edema Questionnaire (BrEQ-Dutch version) to diagnose the presence of breast edema in breast cancer patients

Abstract: Development and clinimetric properties of the Dutch Breast Edema Questionnaire (BrEQ-Dutch version) to diagnose the presence of breast edema in breast cancer patients Hanne Verbelen,

Cited by 6 publications

References 27 publications

Assessment of local tissue water in breasts following breast reconstruction with an expander prosthesis or DIEP flap

Assessment of local tissue water in breasts following breast reconstruction with an expander prosthesis or DIEP flap

Reduction of breast lymphoedema secondary to breast cancer: a randomised controlled exercise trial

Quantification of breast lymphoedema following conservative breast cancer treatment: a systematic review

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