| Title |
Lymphedema symptoms and limb measurement changes in breast cancer survivors treated with neoadjuvant chemotherapy and axillary dissection: results of American College of Surgeons Oncology Group (ACOSOG) Z1071 (Alliance) substudy
|
|---|---|
| Published in |
Supportive Care in Cancer, July 2018
|
| DOI | 10.1007/s00520-018-4334-7 |
| Pubmed ID | |
| Authors |
Jane M. Armer, Karla V. Ballman, Linda McCall, Nathan C. Armer, Yuanlu Sun, Tipparat Udmuangpia, Kelly K. Hunt, Elizabeth A. Mittendorf, David R. Byrd, Thomas B. Julian, Judy C. Boughey |
| Abstract |
Lymphedema is a potential complication of breast cancer treatment. This longitudinal substudy aimed to prospectively assess arm measurements and symptoms following neoadjuvant chemotherapy and axillary dissection in the ACOSOG/Alliance Z1071 trial to characterize the optimal approach to define lymphedema. Z1071 enrolled patients with cT0-4, N1-2, M0 disease treated with neoadjuvant chemotherapy. All patients underwent axillary dissection. Bilateral limb volumes, circumferences, and related symptoms were assessed pre-surgery, 1-2 weeks post-surgery, and semiannually for 36 months. Lymphedema definitions included volume increase ≥ 10% or limb circumference increase ≥ 2 cm. Symptoms were assessed by the Lymphedema Breast Cancer Questionnaire. In 488 evaluable patients, lymphedema incidence at 3 years by ≥ 10%-volume-increase was 60.3% (95% CI 55.0-66.2%) and by ≥ 2 cm-circumference increase was 75.4% (95% CI 70.8-80.2%). Symptoms of arm swelling and heaviness decreased from post-surgery for the first 18 months and then were relatively stable. The 3-year cumulative incidence of arm swelling and heaviness was 26.0% (95% CI 21.7-31.1%) and 30.9% (95% CI 26.3-36.3%), respectively. There was limited agreement between the two measurements (kappa 0.27) and between symptoms and measurements (kappa coefficients ranging from 0.05-0.09). Lymphedema incidence by limb volume and circumference gradually increased over 36 months post-surgery, whereas lymphedema symptoms were much lower. These findings underscore the importance of prospective surveillance and evaluation of both limb measurements and symptom assessment. Lymphedema incidence rates varied by definition. We recommend that ≥ 10% volume change criterion be used for lymphedema evaluation for referral for specialist care. NCT00881361. |
X Demographics
The data shown below were collected from the profiles of 15 X users who shared this research output. Click here to find out more about how the information was compiled.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| United Kingdom | 6 | 40% |
| United States | 5 | 33% |
| Australia | 1 | 7% |
| Unknown | 3 | 20% |
Demographic breakdown
| Type | Count | As % |
|---|---|---|
| Members of the public | 10 | 67% |
| Practitioners (doctors, other healthcare professionals) | 3 | 20% |
| Science communicators (journalists, bloggers, editors) | 1 | 7% |
| Scientists | 1 | 7% |
Mendeley readers
The data shown below were compiled from readership statistics for 77 Mendeley readers of this research output. Click here to see the associated Mendeley record.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Unknown | 77 | 100% |
Demographic breakdown
| Readers by professional status | Count | As % |
|---|---|---|
| Student > Ph. D. Student | 10 | 13% |
| Student > Bachelor | 7 | 9% |
| Student > Master | 6 | 8% |
| Researcher | 6 | 8% |
| Student > Doctoral Student | 4 | 5% |
| Other | 16 | 21% |
| Unknown | 28 | 36% |
| Readers by discipline | Count | As % |
|---|---|---|
| Medicine and Dentistry | 27 | 35% |
| Nursing and Health Professions | 10 | 13% |
| Unspecified | 2 | 3% |
| Engineering | 2 | 3% |
| Pharmacology, Toxicology and Pharmaceutical Science | 1 | 1% |
| Other | 4 | 5% |
| Unknown | 31 | 40% |
Attention Score in Context
This research output has an Altmetric Attention Score of 21. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 15 February 2020.
All research outputs
#1,545,551
of 23,094,276 outputs
Outputs from Supportive Care in Cancer
#186
of 4,652 outputs
Outputs of similar age
#34,835
of 327,716 outputs
Outputs of similar age from Supportive Care in Cancer
#10
of 108 outputs
Altmetric has tracked 23,094,276 research outputs across all sources so far. Compared to these this one has done particularly well and is in the 93rd percentile: it's in the top 10% of all research outputs ever tracked by Altmetric.
So far Altmetric has tracked 4,652 research outputs from this source. They typically receive a little more attention than average, with a mean Attention Score of 5.7. This one has done particularly well, scoring higher than 95% of its peers.
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We're also able to compare this research output to 108 others from the same source and published within six weeks on either side of this one. This one has done particularly well, scoring higher than 90% of its contemporaries.