4.5 Article

Prospective surveillance model in the home for breast cancer-related lymphoedema: a feasibility study

Journal

BREAST CANCER RESEARCH AND TREATMENT
Volume 185, Issue 2, Pages 401-412

Publisher

SPRINGER
DOI: 10.1007/s10549-020-05953-3

Keywords

Breast cancer-related lymphoedema; Bioimpedance spectroscopy (BIS); Home monitoring; Prospective surveillance model; Phase I trial; Feasibility

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Funding

  1. ImpediMed Limited
  2. Sydney Vital Research grant

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The study found that the prospective surveillance model in the home with BIS is feasible and leads to increased self-management. A Phase II randomized trial is needed, as well as research into the costs of implementing this model of care for high-risk individuals.
Purpose The aim of this study was to assess the feasibility of delivering a prospective surveillance model in the home over 6 months for women at high risk of developing lymphoedema. Methods A single-group, intervention study recruited 20 women who had surgical and medical treatment for confirmed node-positive invasive breast cancer and therefore at high risk of developing arm lymphoedema. Participants received a package including Bioimpedance Spectroscopy (BIS) monitoring, lymphoedema education and support to promote self-management and physical activity. Results Participants adhered to BIS monitoring 74% of the time, and felt extremely confident in using the device. By 6 months, mean BIS L-Dex scores had increased from 3.5 (SD 5.6) to 8.4 (SD 11.1); five women (25%) who experienced > + 6.5 increase in L-Dex score were fitted with a compression garment. Self-reported symptoms and distress decreased by 0.4 out of 10 (95% CI 0.1 to 0.7); number of self-management strategies used increased by 0.6 (95% CI 0.1 to 1.2); and planned exercise increased by 2.8 h/week (95% CI 0.4 to 5.2). Conclusions These findings indicate a prospective surveillance model of care in the home with BIS is feasible and associated with increased self-management. A Phase II randomised trial is warranted as well as research exploring the costs associated with implementing this model of care for high-risk individuals.

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