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<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">Diagnosis and Treatment of Lymphedema Following Breast Cancer: A Population-based Study</title><author><name sortKey="Sayko, Oksana" sort="Sayko, Oksana" uniqKey="Sayko O" first="Oksana" last="Sayko">Oksana Sayko</name></author><author><name sortKey="Pezzin, Liliana E" sort="Pezzin, Liliana E" uniqKey="Pezzin L" first="Liliana E." last="Pezzin">Liliana E. Pezzin</name></author><author><name sortKey="Yen, Tina W F" sort="Yen, Tina W F" uniqKey="Yen T" first="Tina W. F." last="Yen">Tina W. F. Yen</name></author><author><name sortKey="Nattinger, Ann B" sort="Nattinger, Ann B" uniqKey="Nattinger A" first="Ann B." last="Nattinger">Ann B. Nattinger</name></author></titleStmt><publicationStmt><idno type="wicri:source">PMC</idno><idno type="pmid">23684778</idno><idno type="pmc">3889213</idno><idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3889213</idno><idno type="RBID">PMC:3889213</idno><idno type="doi">10.1016/j.pmrj.2013.05.005</idno><date when="2013">2013</date><idno type="wicri:Area/Pmc/Corpus">003567</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Corpus" wicri:corpus="PMC">003567</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">Diagnosis and Treatment of Lymphedema Following Breast Cancer: A Population-based Study</title><author><name sortKey="Sayko, Oksana" sort="Sayko, Oksana" uniqKey="Sayko O" first="Oksana" last="Sayko">Oksana Sayko</name></author><author><name sortKey="Pezzin, Liliana E" sort="Pezzin, Liliana E" uniqKey="Pezzin L" first="Liliana E." last="Pezzin">Liliana E. Pezzin</name></author><author><name sortKey="Yen, Tina W F" sort="Yen, Tina W F" uniqKey="Yen T" first="Tina W. F." last="Yen">Tina W. F. Yen</name></author><author><name sortKey="Nattinger, Ann B" sort="Nattinger, Ann B" uniqKey="Nattinger A" first="Ann B." last="Nattinger">Ann B. Nattinger</name></author></analytic><series><title level="j">PM & R : the journal of injury, function, and rehabilitation</title><idno type="ISSN">1934-1482</idno><idno type="eISSN">1934-1563</idno><imprint><date when="2013">2013</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><sec id="S1"><title>Objective</title><p id="P1">To examine factors associated with variations in diagnosis and rehabilitation treatments received by women with self-reported lymphedema secondary to breast cancer care.</p></sec><sec id="S2"><title>Design</title><p id="P2">Population-based, prospective study.</p></sec><sec id="S3"><title>Setting</title><p id="P3">California, Florida, Illinois, New York.</p></sec><sec id="S4"><title>Participants</title><p id="P4">Elderly (65+) women identified from Medicare claims as having had an incident breast cancer surgery in 2003.</p></sec><sec id="S5"><title>Interventions</title><p id="P5">N.A.</p></sec><sec id="S6"><title>Main Outcome Measures</title><p id="P6">Self-reported incidence of lymphedema symptoms, formal lymphedema diagnosis; treatments for lymphedema.</p></sec><sec id="S7"><title>Results</title><p id="P7">Of the 450 breast cancer survivors with lymphedema who participated in the study, 290 (64.4%) were formally diagnosed with the condition by a physician. An additional 160 (35.6%) reported symptoms consistent with lymphedema (arm swelling on the side of surgery that is absent on the contralateral arm) but were not formally diagnosed. Of those reporting as being diagnosed by a physician, 39 (13.4%) received the comprehensive decongestive therapy (CDT) that included multiple components of treatment (manual lymphatic drainage (MLD), bandaging with short stretch bandages, using compression sleeves, skin care and remedial exercises), 24 (8.3%) received MLD only, 162 (55.9%) used bandages, compression garments or a pneumatic pump only, 8 (2.8%) relied solely on skin care or exercise to relieve symptoms and 65 (22.4%) received no treatment at all. Multivariate regressions revealed that race (African American), lower income, and lower levels of social support increased a woman’s probability of having undiagnosed lymphedema. Even when formally diagnosed, African American women were more likely to receive no treatment or to be treated with bandages/compression only, rather than to receive the multi-modality, comprehensive decongestive therapy.</p></sec><sec id="S8"><title>Conclusions</title><p id="P8">Lymphedema is a disabling chronic condition related to breast cancer treatment. Our results suggest that a substantial proportion of those reporting symptoms were not formally diagnosed with the condition, thereby reducing their opportunity for treatment. The variation in rehabilitation treatments received by women who were formally diagnosis with the condition by a physician suggests that lymphedema might not have been optimally addressed in many cases despite availability of effective interventions.</p></sec></div></front></TEI><pmc article-type="research-article"><pmc-comment>The publisher of this article does not allow downloading of the full text in XML form.</pmc-comment>
<pmc-dir>properties manuscript</pmc-dir>
<front><journal-meta><journal-id journal-id-type="nlm-journal-id">101491319</journal-id><journal-id journal-id-type="pubmed-jr-id">36042</journal-id><journal-id journal-id-type="nlm-ta">PM R</journal-id><journal-id journal-id-type="iso-abbrev">PM R</journal-id><journal-title-group><journal-title>PM & R : the journal of injury, function, and rehabilitation</journal-title></journal-title-group><issn pub-type="ppub">1934-1482</issn><issn pub-type="epub">1934-1563</issn></journal-meta><article-meta><article-id pub-id-type="pmid">23684778</article-id><article-id pub-id-type="pmc">3889213</article-id><article-id pub-id-type="doi">10.1016/j.pmrj.2013.05.005</article-id><article-id pub-id-type="manuscript">NIHMS537491</article-id><article-categories><subj-group subj-group-type="heading"><subject>Article</subject></subj-group></article-categories><title-group><article-title>Diagnosis and Treatment of Lymphedema Following Breast Cancer: A Population-based Study</article-title></title-group><contrib-group><contrib contrib-type="author"><name><surname>Sayko</surname><given-names>Oksana</given-names></name><degrees>MD</degrees></contrib><contrib contrib-type="author"><name><surname>Pezzin</surname><given-names>Liliana E.</given-names></name><degrees>PhD</degrees></contrib><contrib contrib-type="author"><name><surname>Yen</surname><given-names>Tina W.F.</given-names></name><degrees>MD</degrees></contrib><contrib contrib-type="author"><name><surname>Nattinger</surname><given-names>Ann B.</given-names></name><degrees>MD, MPH</degrees></contrib><aff id="A1">Department of Physical Medicine and Rehabilitation (OS); Department of Medicine and Center for Patient Care and Outcomes Research (LEP, ABN); and Division of General Surgery (TWY), Medical College of Wisconsin, Milwaukee, WI 53226</aff></contrib-group><author-notes><corresp id="cor1">Send correspondence to Dr. Pezzin. Medical College of Wisconsin, 8701 Watertown Plank Rd., Milwaukee, WI 53226, Telephone 414-456-8862, Fax 414-456-6689, <email>lpezzin@mcw.edu</email></corresp></author-notes><pub-date pub-type="nihms-submitted"><day>12</day><month>12</month><year>2013</year></pub-date><pub-date pub-type="epub"><day>17</day><month>5</month><year>2013</year></pub-date><pub-date pub-type="ppub"><month>11</month><year>2013</year></pub-date><pub-date pub-type="pmc-release"><day>01</day><month>11</month><year>2014</year></pub-date><volume>5</volume><issue>11</issue><fpage>915</fpage><lpage>923</lpage><pmc-comment>elocation-id from pubmed: 10.1016/j.pmrj.2013.05.005</pmc-comment>
<permissions><copyright-statement>© 2013 American Academy of Physical Medicine and Rehabilitation. Published by Elsevier Inc. All rights reserved.</copyright-statement><copyright-year>2013</copyright-year></permissions><abstract><sec id="S1"><title>Objective</title><p id="P1">To examine factors associated with variations in diagnosis and rehabilitation treatments received by women with self-reported lymphedema secondary to breast cancer care.</p></sec><sec id="S2"><title>Design</title><p id="P2">Population-based, prospective study.</p></sec><sec id="S3"><title>Setting</title><p id="P3">California, Florida, Illinois, New York.</p></sec><sec id="S4"><title>Participants</title><p id="P4">Elderly (65+) women identified from Medicare claims as having had an incident breast cancer surgery in 2003.</p></sec><sec id="S5"><title>Interventions</title><p id="P5">N.A.</p></sec><sec id="S6"><title>Main Outcome Measures</title><p id="P6">Self-reported incidence of lymphedema symptoms, formal lymphedema diagnosis; treatments for lymphedema.</p></sec><sec id="S7"><title>Results</title><p id="P7">Of the 450 breast cancer survivors with lymphedema who participated in the study, 290 (64.4%) were formally diagnosed with the condition by a physician. An additional 160 (35.6%) reported symptoms consistent with lymphedema (arm swelling on the side of surgery that is absent on the contralateral arm) but were not formally diagnosed. Of those reporting as being diagnosed by a physician, 39 (13.4%) received the comprehensive decongestive therapy (CDT) that included multiple components of treatment (manual lymphatic drainage (MLD), bandaging with short stretch bandages, using compression sleeves, skin care and remedial exercises), 24 (8.3%) received MLD only, 162 (55.9%) used bandages, compression garments or a pneumatic pump only, 8 (2.8%) relied solely on skin care or exercise to relieve symptoms and 65 (22.4%) received no treatment at all. Multivariate regressions revealed that race (African American), lower income, and lower levels of social support increased a woman’s probability of having undiagnosed lymphedema. Even when formally diagnosed, African American women were more likely to receive no treatment or to be treated with bandages/compression only, rather than to receive the multi-modality, comprehensive decongestive therapy.</p></sec><sec id="S8"><title>Conclusions</title><p id="P8">Lymphedema is a disabling chronic condition related to breast cancer treatment. Our results suggest that a substantial proportion of those reporting symptoms were not formally diagnosed with the condition, thereby reducing their opportunity for treatment. The variation in rehabilitation treatments received by women who were formally diagnosis with the condition by a physician suggests that lymphedema might not have been optimally addressed in many cases despite availability of effective interventions.</p></sec></abstract><kwd-group><kwd>Rehabilitation</kwd><kwd>complete decongestive therapy</kwd><kwd>lymphedema care</kwd><kwd>breast cancer</kwd></kwd-group></article-meta></front></pmc></record>Pour manipuler ce document sous Unix (Dilib)
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