Symptom report in detecting breast cancer-related lymphedema

Mei R Fu,1 Deborah Axelrod,2,3 Charles M Cleland,1 Zeyuan Qiu,4 Amber A Guth,2,3 Robin Kleinman,2 Joan Scagliola,2 Judith Haber1 1College of Nursing, New York University, 2Department of Surgery, NYU School of Medicine, 3NYU Clinical Cancer Center, New York, NY, 4Department of Chemistry and Environme...

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Autores principales:	Fu MR, Axelrod D, Clel, CM, Qiu Z, Guth AA, Kleinman R, Scagliola J, Haber J
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2015
Materias:	Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282
Acceso en línea:	https://doaj.org/article/c6cf8f15ebbd41599b3a6aee7ea2460a
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spelling	oai:doaj.org-article:c6cf8f15ebbd41599b3a6aee7ea2460a2021-12-02T08:46:05ZSymptom report in detecting breast cancer-related lymphedema1179-1314https://doaj.org/article/c6cf8f15ebbd41599b3a6aee7ea2460a2015-10-01T00:00:00Zhttps://www.dovepress.com/symptom-report-in-detecting-breast-cancer-related-lymphedema-peer-reviewed-article-BCTThttps://doaj.org/toc/1179-1314Mei R Fu,1 Deborah Axelrod,2,3 Charles M Cleland,1 Zeyuan Qiu,4 Amber A Guth,2,3 Robin Kleinman,2 Joan Scagliola,2 Judith Haber1 1College of Nursing, New York University, 2Department of Surgery, NYU School of Medicine, 3NYU Clinical Cancer Center, New York, NY, 4Department of Chemistry and Environmental Science, New Jersey Institute of Technology, Newark, NJ, USA 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: screening, risk, swelling, pain, heaviness, sensitivityFu MRAxelrod DClelCMQiu ZGuth AAKleinman RScagliola JHaber JDove Medical PressarticleNeoplasms. Tumors. Oncology. Including cancer and carcinogensRC254-282ENBreast Cancer: Targets and Therapy, Vol 2015, Iss default, Pp 345-352 (2015)
institution	DOAJ
collection	DOAJ
language	EN
topic	Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282
spellingShingle	Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282 Fu MR Axelrod D Clel CM Qiu Z Guth AA Kleinman R Scagliola J Haber J Symptom report in detecting breast cancer-related lymphedema
description	Mei R Fu,1 Deborah Axelrod,2,3 Charles M Cleland,1 Zeyuan Qiu,4 Amber A Guth,2,3 Robin Kleinman,2 Joan Scagliola,2 Judith Haber1 1College of Nursing, New York University, 2Department of Surgery, NYU School of Medicine, 3NYU Clinical Cancer Center, New York, NY, 4Department of Chemistry and Environmental Science, New Jersey Institute of Technology, Newark, NJ, USA 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: screening, risk, swelling, pain, heaviness, sensitivity
format	article
author	Fu MR Axelrod D Clel CM Qiu Z Guth AA Kleinman R Scagliola J Haber J
author_facet	Fu MR Axelrod D Clel CM Qiu Z Guth AA Kleinman R Scagliola J Haber J
author_sort	Fu MR
title	Symptom report in detecting breast cancer-related lymphedema
title_short	Symptom report in detecting breast cancer-related lymphedema
title_full	Symptom report in detecting breast cancer-related lymphedema
title_fullStr	Symptom report in detecting breast cancer-related lymphedema
title_full_unstemmed	Symptom report in detecting breast cancer-related lymphedema
title_sort	symptom report in detecting breast cancer-related lymphedema
publisher	Dove Medical Press
publishDate	2015
url	https://doaj.org/article/c6cf8f15ebbd41599b3a6aee7ea2460a
work_keys_str_mv	AT fumr symptomreportindetectingbreastcancerrelatedlymphedema AT axelrodd symptomreportindetectingbreastcancerrelatedlymphedema AT clel symptomreportindetectingbreastcancerrelatedlymphedema AT cm symptomreportindetectingbreastcancerrelatedlymphedema AT qiuz symptomreportindetectingbreastcancerrelatedlymphedema AT guthaa symptomreportindetectingbreastcancerrelatedlymphedema AT kleinmanr symptomreportindetectingbreastcancerrelatedlymphedema AT scagliolaj symptomreportindetectingbreastcancerrelatedlymphedema AT haberj symptomreportindetectingbreastcancerrelatedlymphedema
_version_	1718398390100819968

Symptom report in detecting breast cancer-related lymphedema

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