BREAST CANCER EDGE TASK FORCE OUTCOMES: Quality of Life and Functional Outcome Measures for Secondary Lymphedema in Breast Cancer Survivors

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Background:Breast cancer survivors who develop lymphedema report a wide range of upper extremity impairments and functional limitations. The reported impairments can lead to difficulty with activities of daily living and a reduction in quality of life. It is important for physical therapists to assess and measure these functional deficits and their effect on quality of life using a reliable outcome measure.Purpose:The purpose of the Breast Cancer EDGE Task Force subgroup review was to identify specific outcome measurement tools that could be recommended to measure quality of life and functional deficits in patients with breast cancer related lymphedema (BCRL).Methods:A systematic literature review was used to appraise the evidence supporting the psychometric properties and clinical utility of outcome measures assessing quality of life and function in patients with BCRL.Results:The Functional Assessment of Cancer Therapy - Breast (FACT-B+4) and Disability of Arm, Shoulder and Hand (DASH) questionnaires received a recommendation of 4, highly recommended for use in patients with BCRL due to their psychometric properties and clinical utility. Three other outcome measures were reviewed. The Lymphoedema Functioning, Disability and Health Questionnaire (Lymph -ICF) and the Upper Limb Lymphedema Measure (ULL-27) received a recommendation of 2A, unable to recommend at this time. The Lymphedema Quality of Life Measure for Limb (LYMQOL) received a 1, not recommended.Conclusion:The Breast Cancer EDGE Task Force recommends the FACT-B+4 and DASH questionnaires to assess the quality of life and function in patients with BCRL. The Lymph-ICF and ULL-27 and LYMQOL tools cannot be recommended at this time. Further research is recommended to determine reliability, validity, and clinical utility of these outcome measures. Other shoulder functional outcome measures that are validated in other patient populations needs to be investigated to determine if application to the BCRL population is appropriate.

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