TY - JOUR
T1 - Axillary web syndrome self-assessment questionnaire
T2 - Initial development and validation
AU - Nevola Teixeira, Luiz Felipe
AU - Veronesi, Paolo
AU - Lohsiriwat, Visnu
AU - Luini, Alberto
AU - Schorr, Mario Casales
AU - Garusi, Cristina
AU - Simoncini, Maria Claudia
AU - Sarian, Luis Otavio Zanatta
AU - Gandini, Sara
AU - Sandrin, Fabio
AU - Rietjens, Mario
PY - 2014/12/1
Y1 - 2014/12/1
N2 - Introduction: Despite the great strides made in medical knowledge, surgery still remains a necessary part of the breast cancer treatment. Surgical procedures still lead to post surgical sequelae. The axillary web syndrome (AWS) is one such sequela, which can lead to disability, reduced arm mobility and compromised quality of life. It is often unidentified and the literature regarding its assessment is limited.To improve diagnosis and patient education, the Screening Test AWS (ST-AWS) questionnaire was drafted and applied at the European Institute of Oncology (EIO). Materials and method: We prospectively recruited patients from October 2012 to December 2012. Patients who underwent sentinel lymph node biopsy and/or axillary dissection procedures were registered. Physical examination was set as a gold standard. Results: 88 patients completed the questionnaire. Among these, 32 patients had axillary web syndrome diagnosed, thus a 36% incidence.The questionnaire achieved a sensitivity of 94%, a specificity of 91%, a positive prevalence value (PPV) of 86%, a negative prevalence value (NPV) of 96% and an accuracy of 92%. Conclusion: Our questionnaire achieves high sensitivity and predictive values, and we would recommend it as a screening-tool for auto-diagnosis of the AWS.The main objective of the questionnaire is to enhance patient and therapist awareness of the problem, and prompt management to shorten the effects of this disability. Moreover, it may offer a tool to enhance body image acceptance after surgery.Further studies whereby the efficacy of the questionnaire is investigated in a larger, heterogeneous group and in different situations are warranted.
AB - Introduction: Despite the great strides made in medical knowledge, surgery still remains a necessary part of the breast cancer treatment. Surgical procedures still lead to post surgical sequelae. The axillary web syndrome (AWS) is one such sequela, which can lead to disability, reduced arm mobility and compromised quality of life. It is often unidentified and the literature regarding its assessment is limited.To improve diagnosis and patient education, the Screening Test AWS (ST-AWS) questionnaire was drafted and applied at the European Institute of Oncology (EIO). Materials and method: We prospectively recruited patients from October 2012 to December 2012. Patients who underwent sentinel lymph node biopsy and/or axillary dissection procedures were registered. Physical examination was set as a gold standard. Results: 88 patients completed the questionnaire. Among these, 32 patients had axillary web syndrome diagnosed, thus a 36% incidence.The questionnaire achieved a sensitivity of 94%, a specificity of 91%, a positive prevalence value (PPV) of 86%, a negative prevalence value (NPV) of 96% and an accuracy of 92%. Conclusion: Our questionnaire achieves high sensitivity and predictive values, and we would recommend it as a screening-tool for auto-diagnosis of the AWS.The main objective of the questionnaire is to enhance patient and therapist awareness of the problem, and prompt management to shorten the effects of this disability. Moreover, it may offer a tool to enhance body image acceptance after surgery.Further studies whereby the efficacy of the questionnaire is investigated in a larger, heterogeneous group and in different situations are warranted.
KW - Breast neoplasms
KW - Breast reconstruction
KW - Lymph node dissection
KW - Physiotherapy
KW - Rehabilitation
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U2 - 10.1016/j.breast.2014.09.001
DO - 10.1016/j.breast.2014.09.001
M3 - Article
C2 - 25261931
AN - SCOPUS:84921945336
VL - 23
SP - 836
EP - 843
JO - Breast
JF - Breast
SN - 0960-9776
IS - 6
ER -