Early surveillance is associated with less incidence and severity of breast cancer–related lymphedema compared with a traditional referral model of care

Louise A. Koelmeyer, Robert J. Borotkanics, Jessica Alcorso, Philip Prah, Caleb J. Winch, Kristine Nakhel, Catherine M. Dean, John Boyages

Research output: Contribution to journalArticleResearchpeer-review

Abstract

Background: Bioimpedance spectroscopy (BIS) has enabled the early identification of breast cancer‐related lymphedema. In this study, differences in health service metrics and in the incidence of breast cancer‐related lymphedema are evaluated in an early surveillance model of care compared with a traditional referral model of care. Methods: In a retrospective analysis of data from 753 women who underwent BIS measures between January 1, 2007 and December 31, 2016, 188 women were assigned to the “early surveillance” group if they began lymphedema monitoring presurgery (n = 121) or within 90 days postsurgery (n = 67), and 285 women were assigned to the “traditional referral” group if they began monitoring after 90 days postsurgery. Health service metrics were calculated as the time to the first BIS measure after 90 days postsurgery, the median follow‐up, and the number of health care visits. Lymphedema was diagnosed based on BIS measures. Results: Women in the early surveillance group received lymphedema care significantly earlier than those in the traditional referral group. However, there was no difference in the number of visits per year to the clinic between groups. Significantly more women in the traditional referral group were diagnosed with clinical lymphedema (stage I‐III, 39 % vs 14%; P < .001) and with greater severity (stage II‐III, 24%) compared with those in the early surveillance group (4%). Conclusions: The current findings support the adoption of an early prospective surveillance model of care using BIS for the early detection and management of breast cancer–related lymphedema.
LanguageEnglish
Pages854-862
Number of pages9
JournalCancer
Volume125
Issue number6
Early online date6 Dec 2018
DOIs
Publication statusPublished - 15 Mar 2019

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Lymphedema
Spectrum Analysis
Referral and Consultation
Incidence
Health Services
Breast Cancer Lymphedema
Delivery of Health Care

Bibliographical note

Copyright the Author(s) 2018. Version archived for private and non-commercial use with the permission of the author/s and according to publisher conditions. For further rights please contact the publisher.

Cite this

@article{06159d81daad40729d1b5594c7bfeb5e,
title = "Early surveillance is associated with less incidence and severity of breast cancer–related lymphedema compared with a traditional referral model of care",
abstract = "Background: Bioimpedance spectroscopy (BIS) has enabled the early identification of breast cancer‐related lymphedema. In this study, differences in health service metrics and in the incidence of breast cancer‐related lymphedema are evaluated in an early surveillance model of care compared with a traditional referral model of care. Methods: In a retrospective analysis of data from 753 women who underwent BIS measures between January 1, 2007 and December 31, 2016, 188 women were assigned to the “early surveillance” group if they began lymphedema monitoring presurgery (n = 121) or within 90 days postsurgery (n = 67), and 285 women were assigned to the “traditional referral” group if they began monitoring after 90 days postsurgery. Health service metrics were calculated as the time to the first BIS measure after 90 days postsurgery, the median follow‐up, and the number of health care visits. Lymphedema was diagnosed based on BIS measures. Results: Women in the early surveillance group received lymphedema care significantly earlier than those in the traditional referral group. However, there was no difference in the number of visits per year to the clinic between groups. Significantly more women in the traditional referral group were diagnosed with clinical lymphedema (stage I‐III, 39 {\%} vs 14{\%}; P < .001) and with greater severity (stage II‐III, 24{\%}) compared with those in the early surveillance group (4{\%}). Conclusions: The current findings support the adoption of an early prospective surveillance model of care using BIS for the early detection and management of breast cancer–related lymphedema.",
keywords = "bioimpedance spectroscopy (BIS), breast cancer-related lymphedema (BCRL), lymphedema, prospective surveillance, screening",
author = "Koelmeyer, {Louise A.} and Borotkanics, {Robert J.} and Jessica Alcorso and Philip Prah and Winch, {Caleb J.} and Kristine Nakhel and Dean, {Catherine M.} and John Boyages",
note = "Copyright the Author(s) 2018. Version archived for private and non-commercial use with the permission of the author/s and according to publisher conditions. For further rights please contact the publisher.",
year = "2019",
month = "3",
day = "15",
doi = "10.1002/cncr.31873",
language = "English",
volume = "125",
pages = "854--862",
journal = "Cancer",
issn = "0008-543X",
publisher = "John Wiley & Sons",
number = "6",

}

Early surveillance is associated with less incidence and severity of breast cancer–related lymphedema compared with a traditional referral model of care. / Koelmeyer, Louise A.; Borotkanics, Robert J.; Alcorso, Jessica; Prah, Philip; Winch, Caleb J.; Nakhel, Kristine; Dean, Catherine M.; Boyages, John.

In: Cancer, Vol. 125, No. 6, 15.03.2019, p. 854-862.

Research output: Contribution to journalArticleResearchpeer-review

TY - JOUR

T1 - Early surveillance is associated with less incidence and severity of breast cancer–related lymphedema compared with a traditional referral model of care

AU - Koelmeyer,Louise A.

AU - Borotkanics,Robert J.

AU - Alcorso,Jessica

AU - Prah,Philip

AU - Winch,Caleb J.

AU - Nakhel,Kristine

AU - Dean,Catherine M.

AU - Boyages,John

N1 - Copyright the Author(s) 2018. Version archived for private and non-commercial use with the permission of the author/s and according to publisher conditions. For further rights please contact the publisher.

PY - 2019/3/15

Y1 - 2019/3/15

N2 - Background: Bioimpedance spectroscopy (BIS) has enabled the early identification of breast cancer‐related lymphedema. In this study, differences in health service metrics and in the incidence of breast cancer‐related lymphedema are evaluated in an early surveillance model of care compared with a traditional referral model of care. Methods: In a retrospective analysis of data from 753 women who underwent BIS measures between January 1, 2007 and December 31, 2016, 188 women were assigned to the “early surveillance” group if they began lymphedema monitoring presurgery (n = 121) or within 90 days postsurgery (n = 67), and 285 women were assigned to the “traditional referral” group if they began monitoring after 90 days postsurgery. Health service metrics were calculated as the time to the first BIS measure after 90 days postsurgery, the median follow‐up, and the number of health care visits. Lymphedema was diagnosed based on BIS measures. Results: Women in the early surveillance group received lymphedema care significantly earlier than those in the traditional referral group. However, there was no difference in the number of visits per year to the clinic between groups. Significantly more women in the traditional referral group were diagnosed with clinical lymphedema (stage I‐III, 39 % vs 14%; P < .001) and with greater severity (stage II‐III, 24%) compared with those in the early surveillance group (4%). Conclusions: The current findings support the adoption of an early prospective surveillance model of care using BIS for the early detection and management of breast cancer–related lymphedema.

AB - Background: Bioimpedance spectroscopy (BIS) has enabled the early identification of breast cancer‐related lymphedema. In this study, differences in health service metrics and in the incidence of breast cancer‐related lymphedema are evaluated in an early surveillance model of care compared with a traditional referral model of care. Methods: In a retrospective analysis of data from 753 women who underwent BIS measures between January 1, 2007 and December 31, 2016, 188 women were assigned to the “early surveillance” group if they began lymphedema monitoring presurgery (n = 121) or within 90 days postsurgery (n = 67), and 285 women were assigned to the “traditional referral” group if they began monitoring after 90 days postsurgery. Health service metrics were calculated as the time to the first BIS measure after 90 days postsurgery, the median follow‐up, and the number of health care visits. Lymphedema was diagnosed based on BIS measures. Results: Women in the early surveillance group received lymphedema care significantly earlier than those in the traditional referral group. However, there was no difference in the number of visits per year to the clinic between groups. Significantly more women in the traditional referral group were diagnosed with clinical lymphedema (stage I‐III, 39 % vs 14%; P < .001) and with greater severity (stage II‐III, 24%) compared with those in the early surveillance group (4%). Conclusions: The current findings support the adoption of an early prospective surveillance model of care using BIS for the early detection and management of breast cancer–related lymphedema.

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