Evidence map›Paper›PMID 32031628›Full record

Observational studyPhysical therapy2020

Lymphedema Signs, Symptoms, and Diagnosis in Women Who Are in Minority and Low-Income Groups and Have Survived Breast Cancer.

Ann Marie Flores, Jason Nelson, Lee Sowles, Rebecca G Stephenson, Kathryn Robinson, Andrea Cheville, Antoinette P Sander, William J Blot

Open access · bronzeAbstract readObservational Study
PubMed Full text at PMC Publisher
In one paragraph

Observational study in Physical therapy, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers.

0numbers the graph read from it
0cells of the map it votes in
9citing papers in PubMed
0.9field-weighted citation impact, top 24% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

9 citing papers in PubMed, 27 citations in OpenAlex.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors at 7 institutions in 1 country.

Ann Marie FloresDepartments of Physical Therapy and Human Movement Sciences and Medical Social Sciences, Northwestern University, Chicago, Illinois; Cancer Survivorship Institute, Robert H. Lurie Comprehensive Cancer Center of Northwestern University, Chicago, IL 60611 (USA).
Jason NelsonBiostatistics Research Center, Institute for Clinical Research and Health Policy Studies, Tufts University Medical Center, Boston, Massachusetts.
Lee SowlesOmKids, Portland, Maine.
Rebecca G StephensonDepartment of Rehabilitation Services, Brigham and Women's Hospital, Boston, Massachusetts.
Kathryn RobinsonSchool of Nursing, University of Maine, Orono, Maine.
Andrea ChevilleDepartment of Physical Medicine and Rehabilitation, Mayo Clinic, Rochester, Minnesota.
Antoinette P SanderDepartment of Physical Therapy and Human Movement Sciences and Medical Social Sciences, Northwestern University.
William J BlotInternational Epidemiology Institute, Rockville, Maryland; and Vanderbilt-Ingram Cancer Center, Vanderbilt University Medical Center, Nashville, Tennessee.
Brigham and Women's Hospital · USInternational Epidemiology Institute · USMayo Clinic · USNorthwestern University · USRobert H. Lurie Comprehensive Cancer Center of Northwestern UniversityUniversity Medical Center · USUniversity of Maine · US

Funding

Southern Community Cohort StudyR01CA092447 · NCI · VANDERBILT UNIVERSITY MEDICAL CENTER · PI BLOT, WILLIAM J., ZHENG, WEI · 2001 to 2015
$74.0M
Southern Community Cancer Survivorship StudyR21CA137483 · NCI · VANDERBILT UNIVERSITY · PI FLORES, ANN MARIE · 2009 to 2010
$375k
NCI NIH HHS R01 CA092447NCI NIH HHS R21 CA137483
6 · The paper itself

Abstract

backgroundBreast cancer-related lymphedema (BCRL) is a well-known side effect of cancer and its treatment with wide-ranging prevalence estimates.

objectiveThis study describes associations between breast cancer-related lymphedema (BCRL) signs, symptoms, and diagnosis for women who were African American, white, or had a low income and survived breast cancer.

designThis is a cross-sectional, observational study that used a computer-assisted telephone interview.

methodsWomen who had survived breast cancer were queried on the presence of 5 lymphedema signs and symptoms (edema in the breast, axilla, arm, and/or hand; tissue fibrosis; pitting; hemosiderin staining; heaviness) and whether they had a diagnosis of BCRL. Relationships between signs/symptoms and diagnosis for each group were evaluated with kappa and chi-square statistics.

resultsThe study sample included 528 women who had survived breast cancer (266 white and 262 African American), with 514 reporting complete data on household income; 45% of the latter reported an annual household income of ≤$20,000. Women who were African American or had a low income were nearly twice as likely as women who were white to have any of 8 signs/symptoms of BCRL. Regardless of race and income, >50% of women with all BCRL signs and symptoms reported that they were not diagnosed with BCRL. LIMITATIONS: The main limitations of our study are the lack of medical chart data and longitudinal design.

conclusionsWomen who were African American or had a low income and had survived breast cancer had a greater burden of BCRL signs and symptoms than women who were white. The lack of a strong association between BCRL signs, symptoms, and diagnosis suggests that BCRL may be underdiagnosed. These findings suggest that more rigorous screening and detection of BCRL-especially for women who are African American or have a low income-may be warranted. Cancer rehabilitation programs may be able to fill this gap.

Indexed as

Cancer SurvivorsMinority GroupsPovertySymptom AssessmentAdultAgedAged, 80 and overBlack or African AmericanBreast NeoplasmsChi-Square DistributionCross-Sectional StudiesEdemaFemaleFibrosisHumansInterviews as Topic

Identifiers

PMID32031628
PMCPMC7246063
OpenAlexW3004785123

What OpenQuestion holds

Textmetadata
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.