25. Upper limb morbidity after treatment for breast cancer: A cross-sectional study of lymphedema and function

Introduction: This study explored the prevalence of impaired upper limb function (ULF) and lymphoedema (LO) after breast cancer treatment, their relationships with each other, quality of life, and with patient/treatment characteristics

A Morbidity Screening Tool for identifying fatigue, pain, upper limb dysfunction and lymphedema after breast cancer treatment: A validity study

Purpose: This study aimed to investigate validity of a newly developed Morbidity Screening Tool (MST) to screen for fatigue, pain, swelling (lymphedema) and arm function after breast cancer treatment. Methods: A cross-sectional study included women attending reviews after completing treatment (surgery, chemotherapy and radiotherapy), without recurrence, who could read English. They completed the MST and comparator questionnaires: Disability of the Arm, Shoulder and Hand questionnaire (DASH), Chronic Pain Grade Questionnaire (CPGQ), Lymphedema and Breast Cancer Questionnaire (LBCQ) and Functional Assessment of Cancer Therapy questionnaire with subscales for fatigue (FACT F) and breast cancer (FACT B + 4). Bilateral combined shoulder ranges of motion were compared (upward reach; hand behind back) and percentage upper limb volume difference (%LVD =/>10% diagnosed as lymphedema) measured with the vertical perometer (400T). Results: 613 of 617 participants completed questionnaires (mean age 62.3 years, SD 10.0; mean time since treatment 63.0 months, SD 46.6) and 417 completed objective testing. Morbidity prevalence was estimated as 35.8%, 21.9%, 19.8% and 34.4% for fatigue, impaired upper limb function, lymphedema and pain respectively. Comparing those self-reporting the presence or absence of each type of morbidity, statistically significant differences in comparator variables supported validity of the MST. Statistically significant correlations resulted between MST scores focussing on impact of morbidity, and comparator variables that reflect function and quality of life. Conclusion: Analysis supports the validity of all four short-forms of the MST as providing indications of both presence of morbidity and impacts on participants' lives. This may facilitate early and appropriate referral for intervention. 2013 Elsevier Ltd. All rights reserved.https://doi.org/10.1016/j.ejon.2013.10.006sch_phy18pub3336pub

Reasons for non-entry of patients with DCIS of the breast into a randomised trial (EORTC 10853)

In EORTC trial 10853, patients with histologically confirmed surgical clearance of ductal carcinoma in situ (DCIS) are being randomised to observation alone or to receive external radiation to the breast (50 Gy). So far, 190 patients have been entered from 27 centres. An analysis has been conducted of patients with DCIS presenting to 6 of the participating hospitals. Within these centres there was a total of 216 patients with biopsy confirmed DCIS, without invasion, between 1985 and 1989. However only 77 (36%) were entered into the trial. The major reason for non-entry was that DCIS was too extensive ( 76 139, 55%), so that in situ disease extended to the margins of excision. Other reasons for exclusion included prior breast cancer (18%), delay in histological diagnosis (6%) and a lump measuring more than 3 cm in diameter (4%). Only 6 patients (4%) refused to take part in the trial. Thus the eventual results of the trial may be applicable only to a minority of patients with DCIS. © 1991.SCOPUS: ar.jinfo:eu-repo/semantics/publishe

Group dynamics in telemedicine-delivered and standard multidisciplinary team meetings: results from the TELEMAM randomised trial

We compared breast cancer professional's perceptions of group dynamics during standard face-to-face and telemedicine-delivered multidisciplinary team meetings. Staff perceptions were measured by a Group Behaviour Inventory (GBl) consisting of 35 positive statements in 10 group behaviour sub scales: physical resources, knowledge resources, shared goals, climate, discussion norms, discussion behaviours, decision making, output, satisfaction and group status. The participants were based at a cancer centre (the Edinburgh Breast Unit) and two district general hospitals (Dumfries and Galloway Royal Infirmary and Queen Margaret Hospital, Dunfermline) in southern Scotland. Thirty-three (73%) of the core breast cancer multidisciplinary team members completed a pre-trial (face-to-face) GBl and 24 (72%) completed a post telemedicine GBl. Eleven professionals completed both. Both GBIs produced high and similar mean scores for the majority of the ten sub-scales. Participants who completed a GBI questionnaire had similar, although slightly lower, levels of positive attitudes to telemedicine-delivered compared to face-to-face breast cancer multidisciplinary meetings. These findings support the role of videoconferencing for facilitating multidisciplinary team working within a managed cancer clinical network. </jats:p