Increases in arm volume predict lymphoedema and quality of life deficits after axillary surgery: a prospective cohort study

Background Lymphoedema develops after axillary clearance (ANC) in 25% of patients. This prospective, multi-centre study compared multi-frequency bioimpedance spectroscopy (BIS) with arm volume measurement to: (1) determine which test has better diagnostic accuracy, (2) identify factors predicting de...

Full description

Saved in:
Bibliographic Details
Published in:British journal of cancer 2020-07, Vol.123 (1), p.17-25
Main Authors: Bundred, Nigel, Foden, Phil, Todd, Chris, Morris, Julie, Watterson, Donna, Purushotham, Arnie, Bramley, Maria, Riches, Katie, Hodgkiss, Tracey, Evans, Abigail, Skene, Anthony, Keeley, Vaughan
Format: Article
Language:English
Subjects:
692/699/67/1347
692/700/784
Adult
Aged
Aged, 80 and over
Arm - pathology
Arm - surgery
Axilla - pathology
Axilla - surgery
Biomedical and Life Sciences
Biomedicine
Breast cancer
Breast Neoplasms - complications
Breast Neoplasms - epidemiology
Breast Neoplasms - pathology
Breast Neoplasms - surgery
Cancer Research
Cohort analysis
Compression
Diagnosis
Drug Resistance
Epidemiology
Female
Humans
Lymph Node Excision - adverse effects
Lymphedema
Lymphedema - epidemiology
Lymphedema - etiology
Lymphedema - pathology
Middle Aged
Molecular Medicine
Oncology
Prospective Studies
Quality of Life
Spectroscopy
Surgery
Surveys and Questionnaires
United Kingdom - epidemiology
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Background Lymphoedema develops after axillary clearance (ANC) in 25% of patients. This prospective, multi-centre study compared multi-frequency bioimpedance spectroscopy (BIS) with arm volume measurement to: (1) determine which test has better diagnostic accuracy, (2) identify factors predicting development of lymphoedema, and its effect on quality-of-life. Methods Participants ( N  = 1100) underwent measurements pre and post-ANC surgery for breast cancer. Relative arm volume increase (RAVI) of >10% diagnosed lymphoedema. Predictors of lymphoedema were determined using logistic regression. Optimal diagnostic method was assessed using diagnostic accuracy. Quality-of-life was assessed using the FACT B + 4 questionnaire. Results Lymphoedema was diagnosed in 22.8% women using RAVI > 10%, 45.6% using BIS criteria, while 24.5% underwent compression sleeve application by 24 months. BMI > 30 was an independent factor for both development ( p  = 0.005) and progression ( p  = 0.015) of lymphoedema. RAVI at 1 month, BMI > 30 and number of involved nodes contributed to a novel scoring model to predict lymphoedema by 36 months. Larger decreases in QoL scores post-surgery occurred in lymphoedema patients ( p   30 predicted lymphoedema diagnosis and progression.
ISSN:0007-0920
1532-1827
DOI:10.1038/s41416-020-0844-4