Michelle J Naughton1, Heshan Liu2, Drew K Seisler2, Jennifer Le-Rademacher3, Jane M Armer4, Jill M Oliveri5, Jeffrey A Sloan6, Karen Hock5, Michael Schwartz7, Gary Unzeitig8, Marianne Melnik9, Lisa D Yee10, Gini F Fleming11, John R Taylor12, Charles Loprinzi13, Electra D Paskett14. 1. Department of Internal Medicine, The Ohio State University, Columbus, Ohio. 2. Mayo Clinic, Rochester, Minnesota. 3. Department of Health Sciences, Mayo Clinic, Rochester, Minnesota. 4. Department of Nursing Research, University of Missouri, Columbia, Missouri. 5. Comprehensive Cancer Center, The Ohio State University, Columbus, Ohio. 6. Division of Oncology & Health Sciences Research, Mayo Clinic College of Medicine, Rochester, Minnesota. 7. Mount Sinai Medical Center, Miami Beach, Florida. 8. City of Laredo, Laredo, Texas. 9. Cancer Research Consortium of West Michigan, Grand Rapids, Michigan. 10. Division of Surgical Oncology, City of Hope, Duarte, California. 11. Department of Hematology/Oncology, University of Chicago, Chicago, Illinois. 12. Alliance for Clinical Trials in Oncology Foundation, Protocol Operations Program Office, Chicago, Illinois. 13. North Central Cancer Treatment Group, Mayo Clinic, Rochester, Minnesota. 14. Department of Medicine, The Ohio State University, Columbus, Ohio.
Abstract
BACKGROUND: Lymphedema is an adverse effect of breast cancer treatment that causes swelling and pain in the arm and hand. We tested 2 lymphedema prevention interventions and their impact on health-related quality of life (HRQOL) in a group-randomized trial at 38 cooperative group sites within the United States. METHODS: Patients were recruited before breast surgery. Sites were randomly assigned to education-only (EO) lymphedema prevention or education plus exercise and physical therapy (LEAP). Lymphedema was defined as a ≥10% difference in arm volume at any time from baseline to 18 months postsurgery. HRQOL was assessed using the Functional Assessment of Cancer Therapy-Breast plus 4 lymphedema items (FACT-B+4). Longitudinal mixed model regression analysis, adjusting for key demographic and clinical variables, examined participants' HRQOL by intervention group and lymphedema status. RESULTS: A total of 547 patients (56% LEAP) were enrolled and completed HRQOL assessments. The results revealed no differences between the interventions in preventing lymphedema (P = .37) or HRQOL (FACT-B+4 total score; P = .8777). At 18 months, the presence of lymphedema was associated with HRQOL at borderline significance (P = .0825). However, African American patients reported greater lymphedema symptoms (P = .0002) and better emotional functioning (P = .0335) than patients of other races or ethnicities. Lower HRQOL during the intervention was associated with younger age (P ≤ .0001), Eastern Cooperative Oncology Group performance status >0 (P = .0002), ≥1 positive lymph nodes (P = .0009), having no education beyond high school (P < .0001), having undergone chemotherapy (P = .0242), and having had only axillary node dissection or sentinel node biopsy versus both (P = .0007). CONCLUSION: The tested interventions did not differ in preventing lymphedema or in HRQOL outcomes. African American women reported greater HRQOL impacts due to lymphedema symptoms than women of other races or ethnicities.
BACKGROUND: Lymphedema is an adverse effect of breast cancer treatment that causes swelling and pain in the arm and hand. We tested 2 lymphedema prevention interventions and their impact on health-related quality of life (HRQOL) in a group-randomized trial at 38 cooperative group sites within the United States. METHODS: Patients were recruited before breast surgery. Sites were randomly assigned to education-only (EO) lymphedema prevention or education plus exercise and physical therapy (LEAP). Lymphedema was defined as a ≥10% difference in arm volume at any time from baseline to 18 months postsurgery. HRQOL was assessed using the Functional Assessment of Cancer Therapy-Breast plus 4 lymphedema items (FACT-B+4). Longitudinal mixed model regression analysis, adjusting for key demographic and clinical variables, examined participants' HRQOL by intervention group and lymphedema status. RESULTS: A total of 547 patients (56% LEAP) were enrolled and completed HRQOL assessments. The results revealed no differences between the interventions in preventing lymphedema (P = .37) or HRQOL (FACT-B+4 total score; P = .8777). At 18 months, the presence of lymphedema was associated with HRQOL at borderline significance (P = .0825). However, African American patients reported greater lymphedema symptoms (P = .0002) and better emotional functioning (P = .0335) than patients of other races or ethnicities. Lower HRQOL during the intervention was associated with younger age (P ≤ .0001), Eastern Cooperative Oncology Group performance status >0 (P = .0002), ≥1 positive lymph nodes (P = .0009), having no education beyond high school (P < .0001), having undergone chemotherapy (P = .0242), and having had only axillary node dissection or sentinel node biopsy versus both (P = .0007). CONCLUSION: The tested interventions did not differ in preventing lymphedema or in HRQOL outcomes. African American women reported greater HRQOL impacts due to lymphedema symptoms than women of other races or ethnicities.
Authors: Ya-Chen Tina Shih; Ying Xu; Janice N Cormier; Sharon Giordano; Sheila H Ridner; Thomas A Buchholz; George H Perkins; Linda S Elting Journal: J Clin Oncol Date: 2009-03-16 Impact factor: 44.544
Authors: Chantal M Ferguson; Meyha N Swaroop; Nora Horick; Melissa N Skolny; Cynthia L Miller; Lauren S Jammallo; Cheryl Brunelle; Jean A O'Toole; Laura Salama; Michelle C Specht; Alphonse G Taghian Journal: J Clin Oncol Date: 2015-12-07 Impact factor: 44.544
Authors: Shoshana M Rosenberg; Anne O'Neill; Karen Sepucha; Kathy D Miller; Chau T Dang; Donald W Northfelt; George W Sledge; Bryan P Schneider; Ann H Partridge Journal: JAMA Netw Open Date: 2022-02-01