Screening for breast cancer-related lymphoedema: self-assessment of symptoms and signs.
INTRODUCTION
In the absence of monitoring programs, those at risk of developing breast cancer-related lymphoedema (BCRL) must detect its development. However, the efficacy of self-assessment for BCRL has not been widely investigated. This study will determine if symptoms and signs of BCRL are associated with lymphoedema detected by bioimpedance spectroscopy (BIS) and whether those with and without BCRL can accurately assess the signs of its presence.


METHODS AND RESULTS
Participants with a history of breast cancer (n = 100) reported the presence/absence of symptoms associated with upper limb BCRL and underwent assessment for pitting oedema and differences in tissue texture between their arms (pinch). BIS detected BCRL in 48 women. Women were more likely to have BIS-detected BCRL if they reported swelling (odds ratio (OR), 58.8; 95% CI, 4.9 to 709.4; p = 0.001) or had inter-limb tissue texture differences in their forearm (OR, 73.5; 95% CI, 7.3 to 736.9; p = < 0.001) or upper arm (OR, 23.9; 95% CI, 2.8 to 201.7; p = 0.003). Agreement between therapist and self-assessment of signs of BCRL was almost perfect (kappa, 0.819 to 0.940). A combination of self-reported swelling and/or self-assessed forearm tissue texture difference identified all cases of BIS-detected BCRL.


CONCLUSION
Participants accurately identified the presence or absence of physical signs of BCRL in their arm. Perceived swelling and differences in tissue texture in the affected arm were associated with, and sensitive to, BIS-detected BCRL. These findings support the use of self-assessment to determine if BCRL is developing, indicating the need for professional assessment.
['Svensson|B J|BJ|', 'Dylke|E S|ES|', 'Ward|L C|LC|', 'Black|D A|DA|', 'Kilbreath|Sharon L|SL|http://orcid.org/0000-0002-8024-8641']
D000328:Adult D000368:Aged D000369:Aged, 80 and over D001132:Arm D000072656:Breast Cancer Lymphedema D001943:Breast Neoplasms D055088:Early Detection of Cancer D005260:Female D006801:Humans D008875:Middle Aged D057566:Self Report D012647:Self-Assessment
Screening Bioimpedance Breast cancer Lymhedema Self-assessmnent