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Early surveillance is associated with less incidence and severity of breast cancer-related lymphedema compared with a traditional referral model of care.
Koelmeyer, Louise A; Borotkanics, Robert J; Alcorso, Jessica; Prah, Philip; Winch, Caleb J; Nakhel, Kristine; Dean, Catherine M; Boyages, John.
Afiliación
  • Koelmeyer LA; Australian Lymphoedema Education, Research and Treatment (ALERT) Program, Department of Clinical Medicine, Faculty of Medicine and Health Sciences, Macquarie University, Sydney, New South Wales, Australia.
  • Borotkanics RJ; Department of Biostatistics and Epidemiology, Auckland University of Technology, Auckland, New Zealand.
  • Alcorso J; Australian Lymphoedema Education, Research and Treatment (ALERT) Program, Department of Clinical Medicine, Faculty of Medicine and Health Sciences, Macquarie University, Sydney, New South Wales, Australia.
  • Prah P; Department of Biostatistics and Epidemiology, Auckland University of Technology, Auckland, New Zealand.
  • Winch CJ; Australian Lymphoedema Education, Research and Treatment (ALERT) Program, Department of Clinical Medicine, Faculty of Medicine and Health Sciences, Macquarie University, Sydney, New South Wales, Australia.
  • Nakhel K; Australian Lymphoedema Education, Research and Treatment (ALERT) Program, Department of Clinical Medicine, Faculty of Medicine and Health Sciences, Macquarie University, Sydney, New South Wales, Australia.
  • Dean CM; Department of Health Professions, Faculty of Medicine and Health Sciences, Macquarie University, Sydney, New South Wales, Australia.
  • Boyages J; Australian Lymphoedema Education, Research and Treatment (ALERT) Program, Department of Clinical Medicine, Faculty of Medicine and Health Sciences, Macquarie University, Sydney, New South Wales, Australia.
Cancer ; 125(6): 854-862, 2019 03 15.
Article en En | MEDLINE | ID: mdl-30521080
BACKGROUND: Bioimpedance spectroscopy (BIS) has enabled the early identification of breast cancer-related lymphedema. In this study, differences in health service metrics and in the incidence of breast cancer-related lymphedema are evaluated in an early surveillance model of care compared with a traditional referral model of care. METHODS: In a retrospective analysis of data from 753 women who underwent BIS measures between January 1, 2007 and December 31, 2016, 188 women were assigned to the "early surveillance" group if they began lymphedema monitoring presurgery (n = 121) or within 90 days postsurgery (n = 67), and 285 women were assigned to the "traditional referral" group if they began monitoring after 90 days postsurgery. Health service metrics were calculated as the time to the first BIS measure after 90 days postsurgery, the median follow-up, and the number of health care visits. Lymphedema was diagnosed based on BIS measures. RESULTS: Women in the early surveillance group received lymphedema care significantly earlier than those in the traditional referral group. However, there was no difference in the number of visits per year to the clinic between groups. Significantly more women in the traditional referral group were diagnosed with clinical lymphedema (stage I-III, 39 % vs 14%; P < .001) and with greater severity (stage II-III, 24%) compared with those in the early surveillance group (4%). CONCLUSIONS: The current findings support the adoption of an early prospective surveillance model of care using BIS for the early detection and management of breast cancer-related lymphedema.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Vigilancia de la Población / Linfedema del Cáncer de Mama Tipo de estudio: Diagnostic_studies / Incidence_studies / Observational_studies / Prognostic_studies / Risk_factors_studies / Screening_studies Límite: Adult / Aged / Female / Humans / Middle aged Idioma: En Revista: Cancer Año: 2019 Tipo del documento: Article País de afiliación: Australia Pais de publicación: Estados Unidos

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Vigilancia de la Población / Linfedema del Cáncer de Mama Tipo de estudio: Diagnostic_studies / Incidence_studies / Observational_studies / Prognostic_studies / Risk_factors_studies / Screening_studies Límite: Adult / Aged / Female / Humans / Middle aged Idioma: En Revista: Cancer Año: 2019 Tipo del documento: Article País de afiliación: Australia Pais de publicación: Estados Unidos