L‐Dex, arm volume, and symptom trajectories 24 months after breast cancer surgery

Autor:	Sarah A. McLaughlin, Nicolas Ajkay, Sheila H. Ridner, Mary S. Dietrich, John Boyages, Chirag Shah, Sarah M. DeSnyder, Louise Koelmeyer
Rok vydání:	2020
Předmět:	0301 basic medicine Cancer Research medicine.medical_specialty Time Factors Breast Neoplasms lcsh:RC254-282 survival 03 medical and health sciences breast cancer 0302 clinical medicine Breast cancer Quality of life medicine Humans Radiology Nuclear Medicine and imaging Prospective Studies Original Research Subclinical infection business.industry Clinical Cancer Research biomarkers Middle Aged lcsh:Neoplasms. Tumors. Oncology. Including cancer and carcinogens Interim analysis medicine.disease Surgery 030104 developmental biology Lymphedema quality of life Oncology 030220 oncology & carcinogenesis Arm Biomarker (medicine) Female Trajectory analysis business Tape measure
Zdroj:	Cancer Medicine Cancer Medicine, Vol 9, Iss 14, Pp 5164-5173 (2020)
ISSN:	2045-7634
DOI:	10.1002/cam4.3188
Popis:	Purpose Study objectives were to examine: (a) biomarker trajectories (change from presurgical baseline values of Lymphedema index (L‐Dex) units and arm volume difference) and symptom cluster scores 24 months after breast cancer surgery and (b) associations of these objective biomarkers and symptom cluster scores. Patient/treatment characteristics influencing trajectories were also evaluated. Methods A secondary analysis of data from the published interim analysis of a randomized parent study was undertaken using trajectory analysis. Five hundred and eight participants included in the prior analysis with 24 months of postsurgical follow‐up were initially measured with bioelectric impedance spectroscopy (BIS) and tape measure (TM) and completed self‐report measures. Patients were reassessed postsurgery for continuing eligibility and then randomized to either BIS or TM groups and measured along with self‐report data at regular and optional* visits 3, 6,12,15*,18, 21*, and 24‐months. Results Three subclinical trajectories were identified for each biomarker (decreasing, stable, increasing) and symptom cluster scores (stable, slight increase/decrease, increasing). Subclinical lymphedema was identified throughout the 24‐month period by each biomarker. An L‐Dex increase at 15 months in the BIS group was noted. The self‐report sets demonstrated contingency coefficients of 0.20 (LSIDS‐A soft tissue, P = .031) and 0.19 (FACTB+4, P = .044) with the L‐Dex unit change trajectories. Conclusions These data support the need for long‐term (24 months) prospective surveillance with frequent assessments (every 3 months) at least 15 months after surgery. Statistically significant convergence of symptom cluster scores with L‐Dex unit change supports BIS as beneficial in the early identification of subclinical lymphedema. Long‐term (24 months) lymphedema prospective surveillance with frequent assessments (every 3 months) at least through 15‐months post‐surgery is indicated. Convergence of symptom cluster scores with L‐Dex unit change supports Bioelectric Impedance Spectroscopy as beneficial in the early identification of sub‐clinical lymphedema.
Databáze:	OpenAIRE
Externí odkaz:	https://explore.openaire.eu/search/publication?articleId=doi_dedup___::46cbb169f44f41b6f0fa51843fa36a02 https://doi.org/10.1002/cam4.3188 Zobrazit plný text záznamu Plný text ve formátu PDF Plný text ve formátu HTML
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