Prospective Lymphedema Surveillance in a Clinic Setting
Identifieur interne : 001948 ( Main/Exploration ); précédent : 001947; suivant : 001949Prospective Lymphedema Surveillance in a Clinic Setting
Auteurs : Janet Chance-Hetzler ; Jane Armer [États-Unis] ; Maggie Van Loo ; Blake Anderson ; Robin Harris ; Rebecca Ewing ; Bob Stewart [États-Unis]Source :
- Journal of Personalized Medicine [ 2075-4426 ] ; 2015.
Abstract
The potential impact of breast cancer-related lymphedema (LE) is quite extensive, yet it often remains under-diagnosed until the later stages. This project examines the effectiveness of prospective surveillance in post-surgical breast cancer patients. A retrospective analysis of 49 out of 100 patients enrolled in a longitudinal prospective study at a Midwestern breast center evaluates: (1) time required for completion of bilateral limb measurements and Lymphedema Breast Cancer Questionnaire (LBCQ); (2) referral to LE management with limb volume increase (LVI) and/or LBCQ symptoms; and (3) cost of LE management at lower LVI (≥5%–≤10%) versus traditional (≥10%). Findings revealed a visit timeframe mean of 40.3 min (range = 25–60); 43.6% of visits were ≤30-min timeframe. Visit and measurement times decreased as clinic staff gained measurement experience; measurement time mean was 17.9 min (range = 16.9–18.9). LBCQ symptoms and LVI were significantly (
Url:
DOI: 10.3390/jpm5030311
PubMed: 26308061
PubMed Central: 4600150
Affiliations:
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E-Mails:<email>chancehetzlerj@missouri.edu</email> (J.C.-H.);<email>blake@expressiveanalytics.com</email> (B.A.);<email>harrisrc@missouri.edu</email> (R.H.);<email>stewartb@missouri.edu</email> (B.S.)</nlm:aff></affiliation></author><author><name sortKey="Armer, Jane" sort="Armer, Jane" uniqKey="Armer J" first="Jane" last="Armer">Jane Armer</name><affiliation><nlm:aff id="af1-jpm-05-00311">Sinclair School of Nursing, University of Missouri-Columbia, S235 School of Nursing Building, Columbia, MO 65211, USA; E-Mails:<email>chancehetzlerj@missouri.edu</email> (J.C.-H.);<email>blake@expressiveanalytics.com</email> (B.A.);<email>harrisrc@missouri.edu</email> (R.H.);<email>stewartb@missouri.edu</email> (B.S.)</nlm:aff></affiliation><affiliation wicri:level="1"><nlm:aff id="af2-jpm-05-00311">Lymphedema Research Laboratory, Sinclair School of Nursing, University of Missouri, DC 116.05, Suite 408, Mizzou North Campus, Columbia, MO 65211, USA</nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Lymphedema Research Laboratory, Sinclair School of Nursing, University of Missouri, DC 116.05, Suite 408, Mizzou North Campus, Columbia, MO 65211</wicri:regionArea><wicri:noRegion>MO 65211</wicri:noRegion></affiliation></author><author><name sortKey="Van Loo, Maggie" sort="Van Loo, Maggie" uniqKey="Van Loo M" first="Maggie" last="Van Loo">Maggie Van Loo</name><affiliation><nlm:aff id="af3-jpm-05-00311">Ellis Fischel Cancer Center, One Hospital Drive, Columbia, MO 65212, USA; E-Mail:<email>vanloomj@health.missouri.edu</email></nlm:aff></affiliation></author><author><name sortKey="Anderson, Blake" sort="Anderson, Blake" uniqKey="Anderson B" first="Blake" last="Anderson">Blake Anderson</name><affiliation><nlm:aff id="af1-jpm-05-00311">Sinclair School of Nursing, University of Missouri-Columbia, S235 School of Nursing Building, Columbia, MO 65211, USA; E-Mails:<email>chancehetzlerj@missouri.edu</email> (J.C.-H.);<email>blake@expressiveanalytics.com</email> (B.A.);<email>harrisrc@missouri.edu</email> (R.H.);<email>stewartb@missouri.edu</email> (B.S.)</nlm:aff></affiliation></author><author><name sortKey="Harris, Robin" sort="Harris, Robin" uniqKey="Harris R" first="Robin" last="Harris">Robin Harris</name><affiliation><nlm:aff id="af1-jpm-05-00311">Sinclair School of Nursing, University of Missouri-Columbia, S235 School of Nursing Building, Columbia, MO 65211, USA; E-Mails:<email>chancehetzlerj@missouri.edu</email> (J.C.-H.);<email>blake@expressiveanalytics.com</email> (B.A.);<email>harrisrc@missouri.edu</email> (R.H.);<email>stewartb@missouri.edu</email> (B.S.)</nlm:aff></affiliation></author><author><name sortKey="Ewing, Rebecca" sort="Ewing, Rebecca" uniqKey="Ewing R" first="Rebecca" last="Ewing">Rebecca Ewing</name><affiliation><nlm:aff id="af4-jpm-05-00311">Statistics Department, University of Missouri-Columbia, 23 Middlebush Hall, Columbia, MO 65211, USA; E-Mail:<email>rje88b@missouri.edu</email></nlm:aff></affiliation></author><author><name sortKey="Stewart, Bob" sort="Stewart, Bob" uniqKey="Stewart B" first="Bob" last="Stewart">Bob Stewart</name><affiliation><nlm:aff id="af1-jpm-05-00311">Sinclair School of Nursing, University of Missouri-Columbia, S235 School of Nursing Building, Columbia, MO 65211, USA; E-Mails:<email>chancehetzlerj@missouri.edu</email> (J.C.-H.);<email>blake@expressiveanalytics.com</email> (B.A.);<email>harrisrc@missouri.edu</email> (R.H.);<email>stewartb@missouri.edu</email> (B.S.)</nlm:aff></affiliation><affiliation wicri:level="1"><nlm:aff id="af2-jpm-05-00311">Lymphedema Research Laboratory, Sinclair School of Nursing, University of Missouri, DC 116.05, Suite 408, Mizzou North Campus, Columbia, MO 65211, USA</nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Lymphedema Research Laboratory, Sinclair School of Nursing, University of Missouri, DC 116.05, Suite 408, Mizzou North Campus, Columbia, MO 65211</wicri:regionArea><wicri:noRegion>MO 65211</wicri:noRegion></affiliation></author></analytic><series><title level="j">Journal of Personalized Medicine</title><idno type="eISSN">2075-4426</idno><imprint><date when="2015">2015</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><p>The potential impact of breast cancer-related lymphedema (LE) is quite extensive, yet it often remains under-diagnosed until the later stages. This project examines the effectiveness of prospective surveillance in post-surgical breast cancer patients. A retrospective analysis of 49 out of 100 patients enrolled in a longitudinal prospective study at a Midwestern breast center evaluates: (1) time required for completion of bilateral limb measurements and Lymphedema Breast Cancer Questionnaire (LBCQ); (2) referral to LE management with limb volume increase (LVI) and/or LBCQ symptoms; and (3) cost of LE management at lower LVI (≥5%–≤10%) versus traditional (≥10%). Findings revealed a visit timeframe mean of 40.3 min (range = 25–60); 43.6% of visits were ≤30-min timeframe. Visit and measurement times decreased as clinic staff gained measurement experience; measurement time mean was 17.9 min (range = 16.9–18.9). LBCQ symptoms and LVI were significantly (<italic>p</italic> < 0.001) correlated to LE referral; six of the nine patients referred (67%) displayed both LBCQ symptoms/LVI. Visits with no symptoms reported did not result in referral, demonstrating the importance of using both indicators when assessing early LE. Lower threshold referral provides compelling evidence of potential cost savings over traditional threshold referral with reported costs of: $3755.00 and $6353.00, respectively (40.9% savings).</p></div></front><back><div1 type="bibliography"><listBibl><biblStruct></biblStruct><biblStruct><analytic><author><name sortKey="Armer, J M" uniqKey="Armer J">J.M. Armer</name></author><author><name sortKey="Stewart, B R" uniqKey="Stewart B">B.R. Stewart</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Armer, J M" uniqKey="Armer J">J.M. Armer</name></author><author><name sortKey="Radina, M E" uniqKey="Radina M">M.E. Radina</name></author><author><name sortKey="Porock, D" uniqKey="Porock D">D. Porock</name></author><author><name sortKey="Culbertson, S D" uniqKey="Culbertson S">S.D. 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Brassard</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Shih, Y C" uniqKey="Shih Y">Y.C. Shih</name></author><author><name sortKey="Xu, Y" uniqKey="Xu Y">Y. Xu</name></author><author><name sortKey="Cormier, J N" uniqKey="Cormier J">J.N. Cormier</name></author><author><name sortKey="Giordano, S" uniqKey="Giordano S">S. Giordano</name></author><author><name sortKey="Ridner, S H" uniqKey="Ridner S">S.H. Ridner</name></author><author><name sortKey="Buchholz, T A" uniqKey="Buchholz T">T.A. Buchholz</name></author><author><name sortKey="Perkins, G H" uniqKey="Perkins G">G.H. Perkins</name></author><author><name sortKey="Elting, L S" uniqKey="Elting L">L.S. Elting</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Moffatt, C J" uniqKey="Moffatt C">C.J. Moffatt</name></author><author><name sortKey="Franks, P J" uniqKey="Franks P">P.J. Franks</name></author><author><name sortKey="Doherty, D" uniqKey="Doherty D">D. Doherty</name></author><author><name sortKey="Williams, A F" uniqKey="Williams A">A.F. Williams</name></author><author><name sortKey="Badger, C" uniqKey="Badger C">C. Badger</name></author><author><name sortKey="Jeffs, E" uniqKey="Jeffs E">E. Jeffs</name></author><author><name sortKey="Bosanquet, N" uniqKey="Bosanquet N">N. Bosanquet</name></author><author><name sortKey="Mortimer, P S" uniqKey="Mortimer P">P.S. Mortimer</name></author></analytic></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct></listBibl></div1></back></TEI><affiliations><list><country><li>États-Unis</li></country></list><tree><noCountry><name sortKey="Anderson, Blake" sort="Anderson, Blake" uniqKey="Anderson B" first="Blake" last="Anderson">Blake Anderson</name><name sortKey="Chance Hetzler, Janet" sort="Chance Hetzler, Janet" uniqKey="Chance Hetzler J" first="Janet" last="Chance-Hetzler">Janet Chance-Hetzler</name><name sortKey="Ewing, Rebecca" sort="Ewing, Rebecca" uniqKey="Ewing R" first="Rebecca" last="Ewing">Rebecca Ewing</name><name sortKey="Harris, Robin" sort="Harris, Robin" uniqKey="Harris R" first="Robin" last="Harris">Robin Harris</name><name sortKey="Van Loo, Maggie" sort="Van Loo, Maggie" uniqKey="Van Loo M" first="Maggie" last="Van Loo">Maggie Van Loo</name></noCountry><country name="États-Unis"><noRegion><name sortKey="Armer, Jane" sort="Armer, Jane" uniqKey="Armer J" first="Jane" last="Armer">Jane Armer</name></noRegion><name sortKey="Stewart, Bob" sort="Stewart, Bob" uniqKey="Stewart B" first="Bob" last="Stewart">Bob Stewart</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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