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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...
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| Published in: | British journal of cancer 2020-07, Vol.123 (1), p.17-25 |
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| container_end_page | 25 |
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| container_title | British journal of cancer |
| container_volume | 123 |
| creator | Bundred, Nigel Foden, Phil Todd, Chris Morris, Julie Watterson, Donna Purushotham, Arnie Bramley, Maria Riches, Katie Hodgkiss, Tracey Evans, Abigail Skene, Anthony Keeley, Vaughan |
| description | 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. |
| doi_str_mv | 10.1038/s41416-020-0844-4 |
| format | article |
| fullrecord | <record><control><sourceid>proquest_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_7341763</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2398158246</sourcerecordid><originalsourceid>FETCH-LOGICAL-c470t-53d6464b5c83667cbcd125ce8df7ce72e71cb9f46dd71b4f792b5ae8a430a86f3</originalsourceid><addsrcrecordid>eNp1kU1rFTEUhgdR7G31B7iRgBs3o_maJONCkGK1UHCj65BJTnpTZibTJHNx8M-bcmv9AFfhcJ7z5rznbZoXBL8hmKm3mRNORIspbrHivOWPmh3pGG2JovJxs8MYyxb3FJ80pznf1LLHSj5tThhlgopO7Zofl7NNYDJkFGZk0oQOcVwnQEsCF2xB4zYt-wgOJoPM7NDtasZQNhQ9GoMH5MAHG0pGxhdIyHwP42jShvKariFt75CpUjEvYEs4ALJxH1NBuaxue9Y88WbM8Pz-PWu-XXz8ev65vfry6fL8w1VrucSl7ZgTXPChs4oJIe1gHaGdBeW8tCApSGKH3nPhnCQD97KnQ2dAGc6wUcKzs-b9UXdZhwmchbkkM-olhaluqqMJ-u_OHPb6Oh60ZJxIwarA63uBFG9XyEVPIVuoRmeIa9aU9Yp0inJR0Vf_oDdxTXO1pymn9f6E4b5S5EjZepqcwD8sQ7C-i1Yfo9U1Wn0XreZ15uWfLh4mfmVZAXoEcm3N9fi_v_6_6k954rIq</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2420901309</pqid></control><display><type>article</type><title>Increases in arm volume predict lymphoedema and quality of life deficits after axillary surgery: a prospective cohort study</title><source>Open Access: PubMed Central</source><source>Springer Nature</source><creator>Bundred, Nigel ; Foden, Phil ; Todd, Chris ; Morris, Julie ; Watterson, Donna ; Purushotham, Arnie ; Bramley, Maria ; Riches, Katie ; Hodgkiss, Tracey ; Evans, Abigail ; Skene, Anthony ; Keeley, Vaughan</creator><creatorcontrib>Bundred, Nigel ; Foden, Phil ; Todd, Chris ; Morris, Julie ; Watterson, Donna ; Purushotham, Arnie ; Bramley, Maria ; Riches, Katie ; Hodgkiss, Tracey ; Evans, Abigail ; Skene, Anthony ; Keeley, Vaughan ; Investigators of BEA/PLACE studies ; the Investigators of BEA/PLACE studies</creatorcontrib><description>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
< 0.001). Progression to moderate lymphoedema occurred in 15% patients after sleeve application.
Conclusions
RAVI measurement was the best diagnostic tool for lymphoedema. BIS alone is not appropriate for lymphoedema screening or diagnosis. BMI > 30 predicted lymphoedema diagnosis and progression.</description><identifier>ISSN: 0007-0920</identifier><identifier>EISSN: 1532-1827</identifier><identifier>DOI: 10.1038/s41416-020-0844-4</identifier><identifier>PMID: 32362658</identifier><language>eng</language><publisher>London: Nature Publishing Group UK</publisher><subject>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</subject><ispartof>British journal of cancer, 2020-07, Vol.123 (1), p.17-25</ispartof><rights>The Author(s) 2020</rights><rights>The Author(s) 2020. This work is published under http://creativecommons.org/licenses/by/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c470t-53d6464b5c83667cbcd125ce8df7ce72e71cb9f46dd71b4f792b5ae8a430a86f3</citedby><cites>FETCH-LOGICAL-c470t-53d6464b5c83667cbcd125ce8df7ce72e71cb9f46dd71b4f792b5ae8a430a86f3</cites><orcidid>0000-0001-6007-056X</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC7341763/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC7341763/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,727,780,784,885,27924,27925,53791,53793</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/32362658$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Bundred, Nigel</creatorcontrib><creatorcontrib>Foden, Phil</creatorcontrib><creatorcontrib>Todd, Chris</creatorcontrib><creatorcontrib>Morris, Julie</creatorcontrib><creatorcontrib>Watterson, Donna</creatorcontrib><creatorcontrib>Purushotham, Arnie</creatorcontrib><creatorcontrib>Bramley, Maria</creatorcontrib><creatorcontrib>Riches, Katie</creatorcontrib><creatorcontrib>Hodgkiss, Tracey</creatorcontrib><creatorcontrib>Evans, Abigail</creatorcontrib><creatorcontrib>Skene, Anthony</creatorcontrib><creatorcontrib>Keeley, Vaughan</creatorcontrib><creatorcontrib>Investigators of BEA/PLACE studies</creatorcontrib><creatorcontrib>the Investigators of BEA/PLACE studies</creatorcontrib><title>Increases in arm volume predict lymphoedema and quality of life deficits after axillary surgery: a prospective cohort study</title><title>British journal of cancer</title><addtitle>Br J Cancer</addtitle><addtitle>Br J Cancer</addtitle><description>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
< 0.001). Progression to moderate lymphoedema occurred in 15% patients after sleeve application.
Conclusions
RAVI measurement was the best diagnostic tool for lymphoedema. BIS alone is not appropriate for lymphoedema screening or diagnosis. BMI > 30 predicted lymphoedema diagnosis and progression.</description><subject>692/699/67/1347</subject><subject>692/700/784</subject><subject>Adult</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Arm - pathology</subject><subject>Arm - surgery</subject><subject>Axilla - pathology</subject><subject>Axilla - surgery</subject><subject>Biomedical and Life Sciences</subject><subject>Biomedicine</subject><subject>Breast cancer</subject><subject>Breast Neoplasms - complications</subject><subject>Breast Neoplasms - epidemiology</subject><subject>Breast Neoplasms - pathology</subject><subject>Breast Neoplasms - surgery</subject><subject>Cancer Research</subject><subject>Cohort analysis</subject><subject>Compression</subject><subject>Diagnosis</subject><subject>Drug Resistance</subject><subject>Epidemiology</subject><subject>Female</subject><subject>Humans</subject><subject>Lymph Node Excision - adverse effects</subject><subject>Lymphedema</subject><subject>Lymphedema - epidemiology</subject><subject>Lymphedema - etiology</subject><subject>Lymphedema - pathology</subject><subject>Middle Aged</subject><subject>Molecular Medicine</subject><subject>Oncology</subject><subject>Prospective Studies</subject><subject>Quality of Life</subject><subject>Spectroscopy</subject><subject>Surgery</subject><subject>Surveys and Questionnaires</subject><subject>United Kingdom - epidemiology</subject><issn>0007-0920</issn><issn>1532-1827</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><recordid>eNp1kU1rFTEUhgdR7G31B7iRgBs3o_maJONCkGK1UHCj65BJTnpTZibTJHNx8M-bcmv9AFfhcJ7z5rznbZoXBL8hmKm3mRNORIspbrHivOWPmh3pGG2JovJxs8MYyxb3FJ80pznf1LLHSj5tThhlgopO7Zofl7NNYDJkFGZk0oQOcVwnQEsCF2xB4zYt-wgOJoPM7NDtasZQNhQ9GoMH5MAHG0pGxhdIyHwP42jShvKariFt75CpUjEvYEs4ALJxH1NBuaxue9Y88WbM8Pz-PWu-XXz8ev65vfry6fL8w1VrucSl7ZgTXPChs4oJIe1gHaGdBeW8tCApSGKH3nPhnCQD97KnQ2dAGc6wUcKzs-b9UXdZhwmchbkkM-olhaluqqMJ-u_OHPb6Oh60ZJxIwarA63uBFG9XyEVPIVuoRmeIa9aU9Yp0inJR0Vf_oDdxTXO1pymn9f6E4b5S5EjZepqcwD8sQ7C-i1Yfo9U1Wn0XreZ15uWfLh4mfmVZAXoEcm3N9fi_v_6_6k954rIq</recordid><startdate>20200707</startdate><enddate>20200707</enddate><creator>Bundred, Nigel</creator><creator>Foden, Phil</creator><creator>Todd, Chris</creator><creator>Morris, Julie</creator><creator>Watterson, Donna</creator><creator>Purushotham, Arnie</creator><creator>Bramley, Maria</creator><creator>Riches, Katie</creator><creator>Hodgkiss, Tracey</creator><creator>Evans, Abigail</creator><creator>Skene, Anthony</creator><creator>Keeley, Vaughan</creator><general>Nature Publishing Group UK</general><general>Nature Publishing Group</general><scope>C6C</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7TO</scope><scope>7U9</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8C1</scope><scope>8FE</scope><scope>8FH</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AN0</scope><scope>AZQEC</scope><scope>BBNVY</scope><scope>BENPR</scope><scope>BHPHI</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>H94</scope><scope>HCIFZ</scope><scope>K9.</scope><scope>KB0</scope><scope>LK8</scope><scope>M0S</scope><scope>M1P</scope><scope>M7P</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>7X8</scope><scope>5PM</scope><orcidid>https://orcid.org/0000-0001-6007-056X</orcidid></search><sort><creationdate>20200707</creationdate><title>Increases in arm volume predict lymphoedema and quality of life deficits after axillary surgery: a prospective cohort study</title><author>Bundred, Nigel ; Foden, Phil ; Todd, Chris ; Morris, Julie ; Watterson, Donna ; Purushotham, Arnie ; Bramley, Maria ; Riches, Katie ; Hodgkiss, Tracey ; Evans, Abigail ; Skene, Anthony ; Keeley, Vaughan</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c470t-53d6464b5c83667cbcd125ce8df7ce72e71cb9f46dd71b4f792b5ae8a430a86f3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>692/699/67/1347</topic><topic>692/700/784</topic><topic>Adult</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Arm - pathology</topic><topic>Arm - surgery</topic><topic>Axilla - pathology</topic><topic>Axilla - surgery</topic><topic>Biomedical and Life Sciences</topic><topic>Biomedicine</topic><topic>Breast cancer</topic><topic>Breast Neoplasms - complications</topic><topic>Breast Neoplasms - epidemiology</topic><topic>Breast Neoplasms - pathology</topic><topic>Breast Neoplasms - surgery</topic><topic>Cancer Research</topic><topic>Cohort analysis</topic><topic>Compression</topic><topic>Diagnosis</topic><topic>Drug Resistance</topic><topic>Epidemiology</topic><topic>Female</topic><topic>Humans</topic><topic>Lymph Node Excision - adverse effects</topic><topic>Lymphedema</topic><topic>Lymphedema - epidemiology</topic><topic>Lymphedema - etiology</topic><topic>Lymphedema - pathology</topic><topic>Middle Aged</topic><topic>Molecular Medicine</topic><topic>Oncology</topic><topic>Prospective Studies</topic><topic>Quality of Life</topic><topic>Spectroscopy</topic><topic>Surgery</topic><topic>Surveys and Questionnaires</topic><topic>United Kingdom - epidemiology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Bundred, Nigel</creatorcontrib><creatorcontrib>Foden, Phil</creatorcontrib><creatorcontrib>Todd, Chris</creatorcontrib><creatorcontrib>Morris, Julie</creatorcontrib><creatorcontrib>Watterson, Donna</creatorcontrib><creatorcontrib>Purushotham, Arnie</creatorcontrib><creatorcontrib>Bramley, Maria</creatorcontrib><creatorcontrib>Riches, Katie</creatorcontrib><creatorcontrib>Hodgkiss, Tracey</creatorcontrib><creatorcontrib>Evans, Abigail</creatorcontrib><creatorcontrib>Skene, Anthony</creatorcontrib><creatorcontrib>Keeley, Vaughan</creatorcontrib><creatorcontrib>Investigators of BEA/PLACE studies</creatorcontrib><creatorcontrib>the Investigators of BEA/PLACE studies</creatorcontrib><collection>Springer Nature OA Free Journals</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Proquest Nursing & Allied Health Source</collection><collection>Oncogenes and Growth Factors Abstracts</collection><collection>Virology and AIDS Abstracts</collection><collection>ProQuest - Health & Medical Complete保健、医学与药学数据库</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>ProQuest Public Health Database</collection><collection>ProQuest SciTech Collection</collection><collection>ProQuest Natural Science Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni)</collection><collection>ProQuest Central UK/Ireland</collection><collection>British Nursing Database</collection><collection>ProQuest Central Essentials</collection><collection>Biological Science Collection</collection><collection>AUTh Library subscriptions: ProQuest Central</collection><collection>ProQuest Natural Science Collection</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>SciTech Premium Collection</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Biological Sciences</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>PML(ProQuest Medical Library)</collection><collection>Biological Science Database</collection><collection>Nursing & Allied Health Premium</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>British journal of cancer</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Bundred, Nigel</au><au>Foden, Phil</au><au>Todd, Chris</au><au>Morris, Julie</au><au>Watterson, Donna</au><au>Purushotham, Arnie</au><au>Bramley, Maria</au><au>Riches, Katie</au><au>Hodgkiss, Tracey</au><au>Evans, Abigail</au><au>Skene, Anthony</au><au>Keeley, Vaughan</au><aucorp>Investigators of BEA/PLACE studies</aucorp><aucorp>the Investigators of BEA/PLACE studies</aucorp><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Increases in arm volume predict lymphoedema and quality of life deficits after axillary surgery: a prospective cohort study</atitle><jtitle>British journal of cancer</jtitle><stitle>Br J Cancer</stitle><addtitle>Br J Cancer</addtitle><date>2020-07-07</date><risdate>2020</risdate><volume>123</volume><issue>1</issue><spage>17</spage><epage>25</epage><pages>17-25</pages><issn>0007-0920</issn><eissn>1532-1827</eissn><abstract>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
< 0.001). Progression to moderate lymphoedema occurred in 15% patients after sleeve application.
Conclusions
RAVI measurement was the best diagnostic tool for lymphoedema. BIS alone is not appropriate for lymphoedema screening or diagnosis. BMI > 30 predicted lymphoedema diagnosis and progression.</abstract><cop>London</cop><pub>Nature Publishing Group UK</pub><pmid>32362658</pmid><doi>10.1038/s41416-020-0844-4</doi><tpages>9</tpages><orcidid>https://orcid.org/0000-0001-6007-056X</orcidid><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0007-0920 |
| ispartof | British journal of cancer, 2020-07, Vol.123 (1), p.17-25 |
| issn | 0007-0920 1532-1827 |
| language | eng |
| recordid | cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_7341763 |
| source | Open Access: PubMed Central; Springer Nature |
| 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 |
| title | Increases in arm volume predict lymphoedema and quality of life deficits after axillary surgery: a prospective cohort study |
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