Kilbreath S

A prospective study was conducted to identify women at increased risk for lymphoedema (LE) based on axillary surgery. Assessment occurred prior to surgery, within 4 weeks, and at 6, 12 and 18 months following surgery. Following post-surgery assessment, women were asked to complete weekly diaries regarding events that occurred in the previous week. Risk factors were grouped into demographic, lifestyle, breast cancer treatment-related, arm swelling-related, and post-surgical activities. Bioimpedance spectroscopy thresholds were used to determine presence of LE...

BACKGROUND: Our aims were to determine if and how advice regarding physical rehabilitation (arm-specific and general exercise) was provided after treatment for breast cancer, as well as the prevalence of physical impairments following treatment for breast cancer in an Australian population. METHODS: Members of the Review and Survey Group of the Breast Cancer Network Australia participated in a validated web-based survey. RESULTS: Participants included 186 women who underwent axillary node dissection and 201 who underwent sentinel node biopsy for breast cancer...

The purpose of this study was to assess the safety and efficacy of progressive resistance training (PRT) in breast cancer. Randomized controlled trials (RCTs) published to November 2013 that reported on the effects of PRT (>6 weeks) on breast cancer-related lymphedema (BCRL) (incidence/exacerbation, arm volume, and symptom severity), physical functioning (upper and lower body muscular strength), and health-related quality of life (HRQoL) in breast cancer patients were included. Of 446 citations retrieved, 15 RCTs in 1,652 patients were included and yielded five studies on BCRL incidence/exacerbation (N = 647), four studies on arm volume (N = 384) and BCRL symptom severity (N = 479), 11 studies on upper body muscular strength (N = 1,252), nine studies on lower body muscular strength (N = 1,079), and seven studies on HRQoL (N = 823)...

BACKGROUND: Detection of early lymphedema is important for effective treatment outcome and reduction of disease burden. The aims of this study were to determine normal inter-limb variance in the hand and four segments of the arm using bioimpedance spectroscopy (BIS) to provide diagnostic thresholds for detection of early lymphedema development, to determine the intra-rater reliability of these measurements, and to compare the inter-limb BIS ratios to differences based on arm circumference measures...

BACKGROUND: The aim of this study was to determine the impact of dominance and severity on tissue composition changes with lymphedema using dual-energy X-ray absorptiometry (DXA), and to determine the relationships between the DXA-determined tissue volumes and the clinical outcomes determined by perometry and bioimpedance spectroscopy. METHODS AND RESULTS: Fifty-six women with secondary lymphedema and 44 women without a history of breast cancer or lymphedema underwent measurement of their upper limbs with DXA, perometry, and bioimpedance spectroscopy...

RATIONALE AND OBJECTIVES: Lymphoscintigraphy may be used for diagnosing secondary lymphedema. Dermal backflow, the presence of radiotracer in dermal lymphatics, is a key clinical feature. Although often reported as present or absent, a scale that assesses the severity of dermal backflow has been previously developed. The aim of this study was to determine the reliability of these two methods of assessment. MATERIALS AND METHODS: Sixteen experienced nuclear medicine physicians assessed the quantity of dermal backflow of 57 lymphoscintigraphy scans using a 4-point descriptive scale that was dichotomized for secondary analysis...

BACKGROUND: Upper limb lymphedema is a possible consequence of the treatment for breast cancer. Accurate detection of swelling is important in implementing appropriate treatment. Currently used diagnostic cut-offs for excess volume have been chosen for ease of use and are not based on normative differences. The aim of this study, therefore, was to determine the normal inter-limb variance for healthy older women and identify statistically-based diagnostic cut-offs for both circumference and volume...

OBJECTIVES: To determine whether bioimpedance spectroscopy was suitable for detection of hand lymphoedema. METHODS: The hands of 50 participants without a history of lymphoedema were measured with perometry and bioimpedance spectroscopy after positioning two ways for three minutes: (a) both hands rested at heart height and (b) the dominant hand at heart height and the non-dominant hand at head height. In addition, 10 women with secondary hand lymphoedema were also measured...

BACKGROUND: Assessment of lymphedema is frequently based upon measuring the increase in volume of the affected region compared to that of a comparable unaffected region. This requires methods that can measure the volume of body regions that are not only accurate and sensitive but also suitable for use in clinical practice. To date, bioimpedance spectroscopy has been used to measure volume increase due to lymphedema in whole arms but excluding the hand. We report here an impedance-based method for the measurement of hand volume...

PURPOSE: This study evaluated the acute effect of massage and compression components of lymphoedema treatment in women with and without arm lymphoedema secondary to breast cancer from a single treatment session. METHODS: Women with (n = 15) and without (n = 15) lymphoedema underwent a single session of lymphatic massage. Following the session, women were randomised to receive or not receive a compression sleeve. Measurements were taken prior to, during, and following the massage as well as 30 min after completion of the massage...

BACKGROUND: Arm lymphedema is routinely assessed by clinicians and researchers, using arm circumference measurements. A protocol was developed for measuring arm circumference independent of medically trained professionals. The aim of this project was to assess the protocol's inter-rater reliability and its coherence with perometry measures. METHODS AND RESULTS: Community-dwelling adults (n = 57), aged 60.2  ± 12.8 years, in good general health, were included in this study...

BACKGROUND: Breast cancer-related lymphedema in the arm is commonly detected by bioelectrical impedance spectroscopy as an increased inter-arm impedance ratio due to the presence of excess lymph in the at-risk arm relative to that of the unaffected arm. The presence of lymphedema is determined by a value of this ratio greater than the mean ratio, plus three standard deviations observed in a comparable healthy population. This threshold value has not been established using the measurement protocols in current practice...

BACKGROUND: Secondary unilateral lymphedema in the leg may occur as a consequence of pelvic surgery and/or radiation therapy, which causes damage to the pelvic lymphatic system. To date, assessment has been typically by manual measurement of the volume excess of the affected leg compared to the contralateral leg. In contrast, the assessment of unilateral arm lymphedema is readily accomplished by the use of bioelectrical impedance spectroscopy (BIS) as an increased inter-arm impedance ratio due to the presence of excess lymph in the affected arm relative to that of the unaffected arm...

To assess the impact of air travel on swelling of the 'at risk' arm of women treated for breast cancer. Women treated for breast cancer from Canada (n = 60) and from within Australia (n = 12) attending a dragon boat regatta in Queensland, Australia participated. Women were measured within 2 weeks prior to their flight, on arrival in Queensland and, for 40 women travelling from Canada, measured again 6 weeks following return to Canada. Changes to extracellular fluid were measured using a single-frequency bioimpedance device (BIA)...

PURPOSE/OBJECTIVES: To describe in greater detail women's experiences receiving advice about arm care and exercise after breast cancer treatment. DESIGN: Cross-sectional survey. SETTING: Three hospitals in Sydney, Australia. SAMPLE: 175 patients with breast cancer recruited 6-15 months after their surgery. METHODS: Patients completed a survey about their perceptions of arm activity after breast cancer and were asked to respond to an open-ended question about their experience receiving advice about arm care and exercise...

A single subject prospective study of the relationship between air travel and lymphedema is reported. This proof of concept study was aimed at assessing the feasibility of using self-measured, inter-limb impedance ratios as a quantitative measure of lymphedema immediately prior to and following flying. The participant, a breast cancer survivor with lymphedema, measured whole arm impedance prior to and following air travel on 20 occasions, varying in duration of between 1 and 9 h, over a 12-month period. Although the inter-arm impedance ratio fluctuated over this time, it generally increased and worsened following flying...

PURPOSE: To determine the relationship between physical methods of measuring lymphedema and self-reported swelling, their reliability, and standard error of measurement. METHOD: Lymphedema in each arm of women with (n = 33) and without (n = 18) unilateral arm lymphedema, secondary to breast cancer was measured by self-report, bioimpedance spectroscopy (BIS), perometer, and the truncated cone method. RESULTS: The physical measurement tools were highly reliable (ICC((2,1)): 0...

PURPOSE/OBJECTIVES: To explore the factors that contribute to women's intention to avoid strenuous arm activity after breast cancer surgery. DESIGN: Cross-sectional survey. SETTING: Three hospitals located in eastern Australia. SAMPLE: 175 patients with breast cancer. METHODS: A survey, based on Protection Motivation Theory, was used to assess whether treatment variables, demographic variables, arm advice, fear, or coping attributes predicted women's intentions to avoid strenuous arm activity...

PURPOSE: To assess whether muscle strength, power and endurance at the affected shoulder were reduced in women treated for breast cancer. Secondly, we assessed whether muscle performance was explained by management or other symptoms. METHODS: Participants were 40 women (mean +/- SD: 56.7 +/- 11.6 yr) who had completed all treatments for breast cancer at least 6 m previously. We measured dynamic concentric strength at one repetition maximum (1RM), endurance at 90% 1RM, and power through a range of 40-100% 1RM for shoulder protractors, extensors and retractors...

The aim was to make bioimpedance spectroscopy (BIS) quantitative for assessment of lymphoedema. Apparent resistivity coefficients were determined for the intra- and extracellular water of arms in a control cohort of women (n = 66). These coefficients were used to predict water volumes in the arms of women with lymphoedema (n = 23) and a separate control group without lymphoedema (n = 13) and to compare these with total arm size measured by perometry. Total arm volume was highly correlated (r = 0.80-0.90) with arm fluid volumes predicted by BIS and the proportional increase in arm size predicted by BIS was not significantly different to that measured by perometry...