Reliable prediction of postmastectomy lymphedema: The Risk Assessment Tool Evaluating Lymphedema.
Identifieur interne : 000578 ( PubMed/Corpus ); précédent : 000577; suivant : 000579Reliable prediction of postmastectomy lymphedema: The Risk Assessment Tool Evaluating Lymphedema.
Auteurs : Marten N. Basta ; Liza C. Wu ; Suhail K. Kanchwala ; Joseph M. Serletti ; Julia C. Tchou ; Stephen J. Kovach ; Joshua Fosnot ; John P. FischerSource :
- American journal of surgery [ 1879-1883 ] ; 2017.
English descriptors
- KwdEn :
- MESH :
- adverse effects : Mastectomy.
- diagnosis : Breast Cancer Lymphedema.
- etiology : Breast Cancer Lymphedema.
- surgery : Breast Neoplasms.
- Adult, Aged, Disease-Free Survival, Female, Humans, Middle Aged, Retrospective Studies, Risk Assessment, Risk Factors.
Abstract
Breast cancer-related lymphedema remains a significant complication post mastectomy. Identifying patients at highest risk may better inform targeted healthcare resource allocation and improve outcomes. This study aims to identify lymphedema predictors after mastectomy to develop a simple, accurate risk assessment tool.
DOI: 10.1016/j.amjsurg.2016.08.016
PubMed: 27745890
Links to Exploration step
pubmed:27745890Le document en format XML
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<author><name sortKey="Basta, Marten N" sort="Basta, Marten N" uniqKey="Basta M" first="Marten N" last="Basta">Marten N. Basta</name>
<affiliation><nlm:affiliation>Department of Plastic Surgery, Brown University and Rhode Island Hospital, Lifespan Health System, Providence, RI, USA. Electronic address: martenbasta@gmail.com.</nlm:affiliation>
</affiliation>
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<author><name sortKey="Wu, Liza C" sort="Wu, Liza C" uniqKey="Wu L" first="Liza C" last="Wu">Liza C. Wu</name>
<affiliation><nlm:affiliation>Division of Plastic Surgery, Perelman School of Medicine at the University of Pennsylvania, University of Pennsylvania Health System, Philadelphia, PA, USA.</nlm:affiliation>
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<author><name sortKey="Kanchwala, Suhail K" sort="Kanchwala, Suhail K" uniqKey="Kanchwala S" first="Suhail K" last="Kanchwala">Suhail K. Kanchwala</name>
<affiliation><nlm:affiliation>Division of Plastic Surgery, Perelman School of Medicine at the University of Pennsylvania, University of Pennsylvania Health System, Philadelphia, PA, USA.</nlm:affiliation>
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<author><name sortKey="Serletti, Joseph M" sort="Serletti, Joseph M" uniqKey="Serletti J" first="Joseph M" last="Serletti">Joseph M. Serletti</name>
<affiliation><nlm:affiliation>Division of Plastic Surgery, Perelman School of Medicine at the University of Pennsylvania, University of Pennsylvania Health System, Philadelphia, PA, USA.</nlm:affiliation>
</affiliation>
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<author><name sortKey="Tchou, Julia C" sort="Tchou, Julia C" uniqKey="Tchou J" first="Julia C" last="Tchou">Julia C. Tchou</name>
<affiliation><nlm:affiliation>Division of Endocrine and Oncology Surgery, Perelman School of Medicine at the University of Pennsylvania, University of Pennsylvania Health System, Philadelphia, PA, USA.</nlm:affiliation>
</affiliation>
</author>
<author><name sortKey="Kovach, Stephen J" sort="Kovach, Stephen J" uniqKey="Kovach S" first="Stephen J" last="Kovach">Stephen J. Kovach</name>
<affiliation><nlm:affiliation>Division of Plastic Surgery, Perelman School of Medicine at the University of Pennsylvania, University of Pennsylvania Health System, Philadelphia, PA, USA.</nlm:affiliation>
</affiliation>
</author>
<author><name sortKey="Fosnot, Joshua" sort="Fosnot, Joshua" uniqKey="Fosnot J" first="Joshua" last="Fosnot">Joshua Fosnot</name>
<affiliation><nlm:affiliation>Division of Plastic Surgery, Perelman School of Medicine at the University of Pennsylvania, University of Pennsylvania Health System, Philadelphia, PA, USA.</nlm:affiliation>
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<author><name sortKey="Fischer, John P" sort="Fischer, John P" uniqKey="Fischer J" first="John P" last="Fischer">John P. Fischer</name>
<affiliation><nlm:affiliation>Division of Plastic Surgery, Perelman School of Medicine at the University of Pennsylvania, University of Pennsylvania Health System, Philadelphia, PA, USA.</nlm:affiliation>
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<sourceDesc><biblStruct><analytic><title xml:lang="en">Reliable prediction of postmastectomy lymphedema: The Risk Assessment Tool Evaluating Lymphedema.</title>
<author><name sortKey="Basta, Marten N" sort="Basta, Marten N" uniqKey="Basta M" first="Marten N" last="Basta">Marten N. Basta</name>
<affiliation><nlm:affiliation>Department of Plastic Surgery, Brown University and Rhode Island Hospital, Lifespan Health System, Providence, RI, USA. Electronic address: martenbasta@gmail.com.</nlm:affiliation>
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<author><name sortKey="Wu, Liza C" sort="Wu, Liza C" uniqKey="Wu L" first="Liza C" last="Wu">Liza C. Wu</name>
<affiliation><nlm:affiliation>Division of Plastic Surgery, Perelman School of Medicine at the University of Pennsylvania, University of Pennsylvania Health System, Philadelphia, PA, USA.</nlm:affiliation>
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<author><name sortKey="Kanchwala, Suhail K" sort="Kanchwala, Suhail K" uniqKey="Kanchwala S" first="Suhail K" last="Kanchwala">Suhail K. Kanchwala</name>
<affiliation><nlm:affiliation>Division of Plastic Surgery, Perelman School of Medicine at the University of Pennsylvania, University of Pennsylvania Health System, Philadelphia, PA, USA.</nlm:affiliation>
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<author><name sortKey="Serletti, Joseph M" sort="Serletti, Joseph M" uniqKey="Serletti J" first="Joseph M" last="Serletti">Joseph M. Serletti</name>
<affiliation><nlm:affiliation>Division of Plastic Surgery, Perelman School of Medicine at the University of Pennsylvania, University of Pennsylvania Health System, Philadelphia, PA, USA.</nlm:affiliation>
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<author><name sortKey="Tchou, Julia C" sort="Tchou, Julia C" uniqKey="Tchou J" first="Julia C" last="Tchou">Julia C. Tchou</name>
<affiliation><nlm:affiliation>Division of Endocrine and Oncology Surgery, Perelman School of Medicine at the University of Pennsylvania, University of Pennsylvania Health System, Philadelphia, PA, USA.</nlm:affiliation>
</affiliation>
</author>
<author><name sortKey="Kovach, Stephen J" sort="Kovach, Stephen J" uniqKey="Kovach S" first="Stephen J" last="Kovach">Stephen J. Kovach</name>
<affiliation><nlm:affiliation>Division of Plastic Surgery, Perelman School of Medicine at the University of Pennsylvania, University of Pennsylvania Health System, Philadelphia, PA, USA.</nlm:affiliation>
</affiliation>
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<author><name sortKey="Fosnot, Joshua" sort="Fosnot, Joshua" uniqKey="Fosnot J" first="Joshua" last="Fosnot">Joshua Fosnot</name>
<affiliation><nlm:affiliation>Division of Plastic Surgery, Perelman School of Medicine at the University of Pennsylvania, University of Pennsylvania Health System, Philadelphia, PA, USA.</nlm:affiliation>
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<author><name sortKey="Fischer, John P" sort="Fischer, John P" uniqKey="Fischer J" first="John P" last="Fischer">John P. Fischer</name>
<affiliation><nlm:affiliation>Division of Plastic Surgery, Perelman School of Medicine at the University of Pennsylvania, University of Pennsylvania Health System, Philadelphia, PA, USA.</nlm:affiliation>
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<series><title level="j">American journal of surgery</title>
<idno type="eISSN">1879-1883</idno>
<imprint><date when="2017" type="published">2017</date>
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<profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Adult</term>
<term>Aged</term>
<term>Breast Cancer Lymphedema (diagnosis)</term>
<term>Breast Cancer Lymphedema (etiology)</term>
<term>Breast Neoplasms (surgery)</term>
<term>Disease-Free Survival</term>
<term>Female</term>
<term>Humans</term>
<term>Mastectomy (adverse effects)</term>
<term>Middle Aged</term>
<term>Retrospective Studies</term>
<term>Risk Assessment</term>
<term>Risk Factors</term>
</keywords>
<keywords scheme="MESH" qualifier="adverse effects" xml:lang="en"><term>Mastectomy</term>
</keywords>
<keywords scheme="MESH" qualifier="diagnosis" xml:lang="en"><term>Breast Cancer Lymphedema</term>
</keywords>
<keywords scheme="MESH" qualifier="etiology" xml:lang="en"><term>Breast Cancer Lymphedema</term>
</keywords>
<keywords scheme="MESH" qualifier="surgery" xml:lang="en"><term>Breast Neoplasms</term>
</keywords>
<keywords scheme="MESH" xml:lang="en"><term>Adult</term>
<term>Aged</term>
<term>Disease-Free Survival</term>
<term>Female</term>
<term>Humans</term>
<term>Middle Aged</term>
<term>Retrospective Studies</term>
<term>Risk Assessment</term>
<term>Risk Factors</term>
</keywords>
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<front><div type="abstract" xml:lang="en">Breast cancer-related lymphedema remains a significant complication post mastectomy. Identifying patients at highest risk may better inform targeted healthcare resource allocation and improve outcomes. This study aims to identify lymphedema predictors after mastectomy to develop a simple, accurate risk assessment tool.</div>
</front>
</TEI>
<pubmed><MedlineCitation Status="MEDLINE" Owner="NLM"><PMID Version="1">27745890</PMID>
<DateCreated><Year>2016</Year>
<Month>10</Month>
<Day>17</Day>
</DateCreated>
<DateCompleted><Year>2017</Year>
<Month>08</Month>
<Day>21</Day>
</DateCompleted>
<DateRevised><Year>2017</Year>
<Month>08</Month>
<Day>21</Day>
</DateRevised>
<Article PubModel="Print-Electronic"><Journal><ISSN IssnType="Electronic">1879-1883</ISSN>
<JournalIssue CitedMedium="Internet"><Volume>213</Volume>
<Issue>6</Issue>
<PubDate><Year>2017</Year>
<Month>Jun</Month>
</PubDate>
</JournalIssue>
<Title>American journal of surgery</Title>
<ISOAbbreviation>Am. J. Surg.</ISOAbbreviation>
</Journal>
<ArticleTitle>Reliable prediction of postmastectomy lymphedema: The Risk Assessment Tool Evaluating Lymphedema.</ArticleTitle>
<Pagination><MedlinePgn>1125-1133.e1</MedlinePgn>
</Pagination>
<ELocationID EIdType="pii" ValidYN="Y">S0002-9610(16)30515-3</ELocationID>
<ELocationID EIdType="doi" ValidYN="Y">10.1016/j.amjsurg.2016.08.016</ELocationID>
<Abstract><AbstractText Label="BACKGROUND" NlmCategory="BACKGROUND">Breast cancer-related lymphedema remains a significant complication post mastectomy. Identifying patients at highest risk may better inform targeted healthcare resource allocation and improve outcomes. This study aims to identify lymphedema predictors after mastectomy to develop a simple, accurate risk assessment tool.</AbstractText>
<AbstractText Label="METHODS" NlmCategory="METHODS">An institutional retrospective review identified all women with breast cancer undergoing mastectomy between January 2000 and July 2013 with postmastectomy lymphedema as the primary outcome. Stepwise multivariate Cox regression identified independent predictors of lymphedema. A simplified risk assessment tool was derived and composite risk estimated for each patient.</AbstractText>
<AbstractText Label="RESULTS" NlmCategory="RESULTS">Of 3,136 patients included, 325 (10.4%) developed lymphedema after a follow-up of 4.2 years. Significant predictors included invasive cancer diagnosis (hazard ratio [HR] = 2.25), postmastectomy radiation (HR = 2.05), age over 65 years (HR = 1.90), and axillary dissection (HR = 1.79). Stratified lymphedema risk by group was defined as follows: low 6.2%, moderate 10.0%, high 16.4%, and extreme 36.4%. The model demonstrated excellent risk discrimination (C = .78).</AbstractText>
<AbstractText Label="CONCLUSIONS" NlmCategory="CONCLUSIONS">Postmastectomy lymphedema incidence was 10.4%. Invasive cancer diagnosis, chemoradiation, and axillary dissection imparted significant risk. The Risk Assessment Tool Evaluating Lymphedema offers accurate risk discrimination ranging from 6.2% to 36.4%. Selective treatment approaches may improve outcomes and delivery of cost-effective healthcare.</AbstractText>
<CopyrightInformation>Copyright © 2016 Elsevier Inc. All rights reserved.</CopyrightInformation>
</Abstract>
<AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Basta</LastName>
<ForeName>Marten N</ForeName>
<Initials>MN</Initials>
<AffiliationInfo><Affiliation>Department of Plastic Surgery, Brown University and Rhode Island Hospital, Lifespan Health System, Providence, RI, USA. Electronic address: martenbasta@gmail.com.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Wu</LastName>
<ForeName>Liza C</ForeName>
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<AffiliationInfo><Affiliation>Division of Plastic Surgery, Perelman School of Medicine at the University of Pennsylvania, University of Pennsylvania Health System, Philadelphia, PA, USA.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Kanchwala</LastName>
<ForeName>Suhail K</ForeName>
<Initials>SK</Initials>
<AffiliationInfo><Affiliation>Division of Plastic Surgery, Perelman School of Medicine at the University of Pennsylvania, University of Pennsylvania Health System, Philadelphia, PA, USA.</Affiliation>
</AffiliationInfo>
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<Author ValidYN="Y"><LastName>Serletti</LastName>
<ForeName>Joseph M</ForeName>
<Initials>JM</Initials>
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<Author ValidYN="Y"><LastName>Tchou</LastName>
<ForeName>Julia C</ForeName>
<Initials>JC</Initials>
<AffiliationInfo><Affiliation>Division of Endocrine and Oncology Surgery, Perelman School of Medicine at the University of Pennsylvania, University of Pennsylvania Health System, Philadelphia, PA, USA.</Affiliation>
</AffiliationInfo>
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<Author ValidYN="Y"><LastName>Kovach</LastName>
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<Author ValidYN="Y"><LastName>Fosnot</LastName>
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<MeshHeading><DescriptorName UI="D000072656" MajorTopicYN="N">Breast Cancer Lymphedema</DescriptorName>
<QualifierName UI="Q000175" MajorTopicYN="Y">diagnosis</QualifierName>
<QualifierName UI="Q000209" MajorTopicYN="Y">etiology</QualifierName>
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<MeshHeading><DescriptorName UI="D001943" MajorTopicYN="N">Breast Neoplasms</DescriptorName>
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<QualifierName UI="Q000009" MajorTopicYN="Y">adverse effects</QualifierName>
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<MeshHeading><DescriptorName UI="D008875" MajorTopicYN="N">Middle Aged</DescriptorName>
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<MeshHeading><DescriptorName UI="D012189" MajorTopicYN="N">Retrospective Studies</DescriptorName>
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<MeshHeading><DescriptorName UI="D012307" MajorTopicYN="N">Risk Factors</DescriptorName>
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<KeywordList Owner="NOTNLM"><Keyword MajorTopicYN="N">Breast cancer</Keyword>
<Keyword MajorTopicYN="N">Lymphedema</Keyword>
<Keyword MajorTopicYN="N">Mastectomy</Keyword>
<Keyword MajorTopicYN="N">Risk modeling</Keyword>
<Keyword MajorTopicYN="N">Risk stratification</Keyword>
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