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J. Pers. Med. 2015, 5(3), 311-325; doi:10.3390/jpm5030311

Prospective Lymphedema Surveillance in a Clinic Setting

1
Sinclair School of Nursing, University of Missouri-Columbia, S235 School of Nursing Building, Columbia, MO 65211, USA
2
Lymphedema Research Laboratory, Sinclair School of Nursing, University of Missouri, DC 116.05, Suite 408, Mizzou North Campus, Columbia, MO 65211, USA
3
Ellis Fischel Cancer Center, One Hospital Drive, Columbia, MO 65212, USA
4
Statistics Department, University of Missouri-Columbia, 23 Middlebush Hall, Columbia, MO 65211, USA
*
Author to whom correspondence should be addressed.
Academic Editor: Stephen B. Liggett
Received: 2 May 2015 / Accepted: 17 August 2015 / Published: 25 August 2015
(This article belongs to the Special Issue Long-term Cancer Survivorship)
View Full-Text   |   Download PDF [302 KB, uploaded 25 August 2015]   |  

Abstract

The potential impact of breast cancer-related lymphedema (LE) is quite extensive, yet it often remains under-diagnosed until the later stages. This project examines the effectiveness of prospective surveillance in post-surgical breast cancer patients. A retrospective analysis of 49 out of 100 patients enrolled in a longitudinal prospective study at a Midwestern breast center evaluates: (1) time required for completion of bilateral limb measurements and Lymphedema Breast Cancer Questionnaire (LBCQ); (2) referral to LE management with limb volume increase (LVI) and/or LBCQ symptoms; and (3) cost of LE management at lower LVI (≥5%–≤10%) versus traditional (≥10%). Findings revealed a visit timeframe mean of 40.3 min (range = 25–60); 43.6% of visits were ≤30-min timeframe. Visit and measurement times decreased as clinic staff gained measurement experience; measurement time mean was 17.9 min (range = 16.9–18.9). LBCQ symptoms and LVI were significantly (p < 0.001) correlated to LE referral; six of the nine patients referred (67%) displayed both LBCQ symptoms/LVI. Visits with no symptoms reported did not result in referral, demonstrating the importance of using both indicators when assessing early LE. Lower threshold referral provides compelling evidence of potential cost savings over traditional threshold referral with reported costs of: $3755.00 and $6353.00, respectively (40.9% savings). View Full-Text
Keywords: lymphedema; surveillance; cost; referral lymphedema; surveillance; cost; referral
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This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. (CC BY 4.0).

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MDPI and ACS Style

Chance-Hetzler, J.; Armer, J.; Van Loo, M.; Anderson, B.; Harris, R.; Ewing, R.; Stewart, B. Prospective Lymphedema Surveillance in a Clinic Setting. J. Pers. Med. 2015, 5, 311-325.

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