The first aim of this research project is to identify what factors motivate patients to seek assessment for early lymphedema and further, to gain insight into the signs and symptoms of developing lymphedema and the concurrent physical measurements. The second aim is to identify other sensory signs and symptoms and changes in body perception which may be perceived by the patient as reflective of lymphedema, and to identify to which degree they contribute to the patients' motivation to seek referral to lymphedema clinics.
One of the most challenging morbidities after breast cancer treatment is lymphedema. Approximately 20% of women treated for breast cancer with axillary lymph node dissection will be diagnosed with lymphedema. Pre- and post-operatively, women are informed about changes suggestive of lymphedema and guided about seeking further assessment. The investigators presume that if symptoms occur, patients will seek assessment. However, it is unknown whether this is true or if those prospectively monitored present earlier for treatment, or whether other factors specifically drive patients to seek further assessment. Understanding the early experience and presentation of secondary lymphedema will improve patient education and detection programs.
Study Type
OBSERVATIONAL
Enrollment
46
University of Sydney, Faculty of Health Sciences
Sydney, New South Wales, Australia
University Hospital Leuven
Leuven, Belgium
Extracellular fluid in the arm
Bioimpedance spectroscopy (BIS) is a measurement tool used to determine the volume of extracellular fluid, of which lymph fluid is a component.
Time frame: immediately after inclusion in the study
Arm volume
Arm circumference measures are commonly used to diagnose and monitor lymphedema.
Time frame: immediately after inclusion in the study
Pitting
The pitting tests examines the responsiveness of tissue to pressure and can be used to help determine the stage of lymphedema.
Time frame: immediately after inclusion in the study
Self-reported signs and symptoms of lymphedema
Norman questionnaire for early detection of lymphedema will be used; this validated questionnaire will allow us to determine the location and severity of the symptoms that the patients have experienced over the past three months as well as how much distress it has caused.
Time frame: immediately after inclusion in the study
Impairments in function, activity limitations, and participation restrictions of patients with arm lymphedema
Lymphoedema Functioning, Disability and Health questionnaire (Lymph-ICF): The Lymph-ICF is a reliable and valid questionnaire to assess impairments in function, activity limitations, and participation restrictions of patients with arm lymphedema.
Time frame: immediately after inclusion in the study
Global Health Status/Quality of Life Score
Health-related quality of life assessed with the generic QLQ-C30 and the disease-specific QLQ-BR23 questionnaire
Time frame: immediately after inclusion in the study
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Body perception
The BATH CRPS body perception disturbances scale: to assess body perception disturbances in breast cancer patients.
Time frame: immediately after inclusion in the study
Pain intensity assessed with the Numeric Rating Scale
Numeric Rating Scale for maximal pain intensity during the past week.
Time frame: immediately after inclusion in the study
Prevalence of neuropathic pain
Measured with the Douleur Neuropathique en 4 questions (DN4)
Time frame: immediately after inclusion in the study
Tactile acuity (Two-point discrimination)
To assess body perception two-point discrimination will be assessed at both arms, the breasts and lateral trunk side.
Time frame: immediately after inclusion in the study
Mechanical detection and pain threshold
The lowest mechanical forces, applied to the skin using nylon monofilaments that the subject can 1) detect and 2) is perceived as painful) are tested at the upper limb and upper body region.
Time frame: immediately after inclusion in the study
Temporal summation
Detection of perceived temporal summation at the upper limb and upper body region tested using repeated 26g nylon monofilament stimulation.
Time frame: immediately after inclusion in the study