Patient-reported outcomes and objective assessments with arm measurement and bioimpedance analysis for lymphedema among breast cancer survivors

Terada, Mitsuo; Yoshimura, Akinobu; Sawaki, Masataka; Hattori, Masao; Gondo, Naomi; Kotani, Hirokazu; Adachi, Yayoi; Iwase, Madoka; Kataoka, Ayumi; Sugino, Kayoko; Mori, Makiko; Horisawa, Nanae; Ozaki, Yuri; Iwata, Hiroji

doi:10.1007/s10549-019-05443-1

Cited by 24 publications

(13 citation statements)

References 39 publications

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“…Goldberg reported on a series of 600 patients received SLNB by combined dye-isotope mapping technique, the incidence of patient-reported lymphedema was 3% [39]. And another report showed that the incidence of subjective lymphedema after SLNB was 4.1% [40]. Therefore, from the results of our study, it seems that SLNB with a dual tracer of combined ICG and MB is not related to an increased risk of lymphedema.…”

Section: Discussionsupporting

confidence: 50%

Long-term follow-up results of fluorescence and blue dye guided sentinel lymph node biopsy in early breast cancer

Wang

Tong

Cao

et al. 2021

Breast Cancer Res Treat

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Purpose This study aimed to assess the value of the combination of indocyanine green (ICG) and methylene blue (MB) dye in early breast cancer patients undergoing sentinel lymph node biopsy (SLNB).Methods Between January 2011 and December 2015, 1061 early breast cancer patients underwent SLNB were included. SLNB was performed for enrolled patients by injection of both ICG and MB. Detection rate, positivity, and number of sentinel lymph nodes (SLNs) by ICG and MB were analysed. Axillary recurrence and arm lymphedema at 5.6 years follow-up were reported.Results The combination of ICG and MB resulted in a very high detection rate of 99.6%, the median number of sentinel lymph nodes was 3. A total of 374 histologically con rmed positive SLNs were detected in 237 patients, 96.6% of the positive patients and 94.1% of the positive nodes could be identi ed by the combination of ICG and MB. After a median follow-up of 5.6 (2 to 9.3) years, 0.64% of patients with negative SLNs had ipsilateral axillary recurrence, and the incidence of arm lymphedema was 2.1%.Conclusions Although the missing isotope control weakens the interpretation of the ndings, the dual tracing modality of ICG and MB, without involvement of radioactive isotopes, was an effective method for SLNB in patients with early breast cancer.

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Section: Discussionsupporting

confidence: 50%

Long-term follow-up results of fluorescence and blue dye guided sentinel lymph node biopsy in early breast cancer

Wang

Tong

Cao

et al. 2021

Breast Cancer Res Treat

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“…Our findings suggest that patients with self-reported BCRL, regardless of whether they have objective BCRL or not, have pain, sensory and perceptual alterations and limitations in daily functioning that may require intervention. Consistent with the literature [15][16][17][18], our results imply that the presence of self-reported BCRL is just a first indication for the need of further evaluation specifically related to BCRL, sensory and perceptual dysfunction and/or pain [23,34,35]. A first explanation why signs and symptoms presentation are similar in both subjective and objective BCRL groups may be the challenges in objectively determining when BCRL is developing.…”

Section: Discussionsupporting

confidence: 88%

“…To date, clarity is lacking on the association of a wide range of signs and symptoms with measurable BCRL. This is illustrated by the fact that up to 40% of the women presenting to lymphedema services with symptoms do not have objective measurable arm swelling [15][16][17][18]. Although patients are educated to seek care when experiencing certain signs and symptoms because of their possible association with BCRL, the relationship between these signs and symptoms, and in particular pain and sensory changes, and the objective measures of BCRL is unclear [4,19].…”

Section: Introductionmentioning

confidence: 99%

Sensory signs and symptoms in women with self-reported breast cancer–related lymphedema: a case–control study close up

et al. 2021

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Purpose: It is not clear to what extent signs and symptoms other than arm swelling, including pain, altered sensory function and body perception disturbances, differ between women with measurable and non-measurable breast cancer-related lymphedema (BCRL). A case-control study was performed to compare these signs and symptoms between 1) women with self-reported BCRL with objectively measurable swelling; 2) women with self-reported BCRL without objective confirmation; and 3) a control group with no self-reported BCRL. Methods:The three groups were compared for 1) the severity of self-reported signs and symptoms of BCRL, 2) problems in functioning related to BCRL, 3) pain-related outcomes, 4) sensory functions and 5) body perception.Results: All self-reported outcomes related to signs and symptoms of BCRL and problems in functioning were significantly different between the control group and the other two groups with and without measurable self-reported BCRL (p<0.001-0.003). Except for 'skin texture' (p=0.01), 'hand swelling' (p=0.301) and 'difficulty writing' (p=0.676), no differences were found between groups. For painrelated outcomes, sensory function and body perception, significant differences were only found for the mechanical detection threshold (p<0.01) and self-reported disturbances in body perception (p<0.001) between the self-reported BCRL groups and control group. Conclusions:Diverse signs and symptoms related to BCRL, sensory function and perception were different among women with self-reported BCRL compared to controls. No differences between women with and without measurable self-reported BCRL were found. Implications:The presence of self-reported BCRL, with or without measurable swelling, is a first indication for the need of further diagnostic evaluation.

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“…Our study reports one of the first clinical experiences utilizing multiple PRO-CTCAE items for patients with breast A Japanese study of over 600 patients with breast cancer analyzed a PRO-CTCAE for lymphedema and found it weakly correlated with arm circumference and bioimpedance (13). A smaller American study on patients undergoing APBI reported skin toxicity using PRO-CTCAE with 31% of patients reporting mild to moderate skin toxicity at the end of radiotherapy and only 15% of patients 12 months post-radiation (14).…”

Section: Discussionmentioning

confidence: 91%

Patient-reported outcomes for patients with breast cancer undergoing radiotherapy: A single-center registry experience

et al. 2022

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BackgroundWe present Patient-Reported Outcomes Version of the Common Terminology Criteria for Adverse Events (PRO-CTCAE) for patients undergoing adjuvant radiotherapy for breast cancer with curative intent. We describe the frequency and severity of PRO-CTCAE and analyze them with respect to dose fractionation.MethodsPatients were included in this study if they were treated with curative intent for breast cancer and enrolled on a prospective registry. Patients must have completed at least one baseline and one post-radiation survey that addressed PRO-CTCAE. For univariate and multivariate analysis, categorical variables were analyzed by Fisher’s exact test and continuous variables by Wilcoxon rank sum test. PRO-CTCAE items graded ≥2 and ≥3 were analyzed between patients who received hypofractionation (HF) versus standard conventional fractionation (CF) therapy by the Chi-square test.ResultsThree hundred thirty-one patients met inclusion criteria. Pathologic tumor stage was T1–T2 in 309 (94%) patients. Eighty-seven (29%) patients were node positive. Two hundred forty-seven patients (75%) experienced any PRO-CTCAE grade ≥2, and 92 (28%) patients experienced any PRO-CTCAE grade ≥3. CF was found to be associated with an increased risk of grade ≥3 skin toxicity, swallowing, and nausea (all p < 0.01). HF (OR 0.48, p < 0.01) was significant in the multivariate model for decreased risk of any occurrence of PRO-CTCAE ≥3.ConclusionsOur study reports one of the first clinical experiences utilizing multiple PRO-CTCAE items for patients with breast cancer undergoing radiation therapy with curative intent. Compared with CF, HF was associated with a significant decrease in any PRO-CTCAE ≥3 after multivariate analysis.

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Patient-reported outcomes and objective assessments with arm measurement and bioimpedance analysis for lymphedema among breast cancer survivors

Cited by 24 publications

References 39 publications

Long-term follow-up results of fluorescence and blue dye guided sentinel lymph node biopsy in early breast cancer

Long-term follow-up results of fluorescence and blue dye guided sentinel lymph node biopsy in early breast cancer

Sensory signs and symptoms in women with self-reported breast cancer–related lymphedema: a case–control study close up

Patient-reported outcomes for patients with breast cancer undergoing radiotherapy: A single-center registry experience

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