Use of technology to facilitate a prospective surveillance program for breast cancer-related lymphedema at the Massachusetts General Hospital.

Autor:	Havens LM; Department of Radiation Oncology, Massachusetts General Hospital, Boston, MA, USA., Brunelle CL; Department of Physical and Occupational Therapy, Massachusetts General Hospital, Boston, MA, USA., Gillespie TC; Department of Radiation Oncology, Massachusetts General Hospital, Boston, MA, USA., Bernstein M; Department of Radiation Oncology, Massachusetts General Hospital, Boston, MA, USA., Bucci LK; Department of Radiation Oncology, Massachusetts General Hospital, Boston, MA, USA., Kassamani YW; Department of Radiation Oncology, Massachusetts General Hospital, Boston, MA, USA., Taghian AG; Department of Radiation Oncology, Massachusetts General Hospital, Boston, MA, USA.
Jazyk:	angličtina
Zdroj:	MHealth [Mhealth] 2021 Jan 20; Vol. 7, pp. 11. Date of Electronic Publication: 2021 Jan 20 (Print Publication: 2021).
DOI:	10.21037/mhealth-19-218
Abstrakt:	Breast cancer-related lymphedema (BCRL) is a negative sequela of breast cancer (BC) caused by trauma to the lymphatic system during surgery or radiation to the axillary lymph nodes. BCRL affects approximately one in five patients treated for BC, and patients are at a lifelong risk for BCRL after treatment. Early diagnosis of BCRL may prevent its progression and reduce negative effects on quality of life, necessitating comprehensive prospective screening. This paper provides an overview of technology that may be used as part of a BCRL screening program, including objective measures such as perometry, bioimpedance spectroscopy, tissue tonometry, and three-dimensional optical imaging. Furthermore, this paper comprehensively reviews the technology incorporated into the established prospective screening program at Massachusetts General Hospital. Our prospective screening program consists of longitudinal measurements via perometry, symptoms assessment, and clinical examination by a certified lymphedema therapist (CLT) as needed. Discussion about use of perometry within the screening program and incorporation of arm volume measurements into equations to determine change over time and accurate diagnosis is included [relative volume change (RVC) and weight-adjusted change (WAC) equations]. Use of technology throughout the program is discussed, including a HIPPA-compliant online research database, the patient's electronic medical record, and incorporation of BCRL-related symptoms [BC and lymphedema symptom experience index (BCLE-SEI) survey]. Ultimately, both subjective and objective data are used to inform BCRL diagnosis and treatment by the CLT. In conclusion, the role of technology in facilitating BCRL screening is indispensable, and the continued development of objective assessment methods that are not only reliable and valid, but also cost-effective and portable will help establish BCRL screening as the standard of care for patients treated for BC. Competing Interests: Conflicts of Interest: All authors have completed the ICMJE uniform disclosure form (http://dx.doi.org/10.21037/mhealth-19-218). The series “Real-Time Detection and Management of Chronic Illnesses” was commissioned by the editorial office without any funding or sponsorship. CLB reports grants from the National Cancer Institute, funding from the Adele McKinnon Research Fund for Breast Cancer-Related Lymphedema, the Heinz Family Foundation, and from Olayan-Xefos Family Fund for Breast Cancer Research, during the conduct of the study; personal fees from PureTech Health, outside the submitted work. AGT reports grants from National Cancer Institute, funding from the Adele McKinnon Research Fund for Breast Cancer-Related Lymphedema, the Heinz Family Foundation, and the Olayan-Xefos Family Fund for Breast Cancer Research, during the conduct of the study; personal fees from PureTech Health, equipment loaned from Impedimed, outside the submitted work. The authors have no other conflicts of interest to declare. (2021 mHealth. All rights reserved.)
Databáze:	MEDLINE
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