Investigation of responsiveness of the outcome measurement scales in breast cancer related arm lymphedema

Objective: The aim of this study is to compare the responsiveness of the scales of the end state criteria in breast cancer-associated lymphedema. Materials and Methods: Forty patients who developed post-mastectomy lymphedema were included in the study and complex decongestive therapy was administered for four weeks in phase 1. Lymphedema Life Impact Scale (LLIS), Lymphedema Functioning, Disability and Health Questionnaire (Lymph-ICF), Quality of Life Scale-Arm (LYMQOL), Patient Benefit Index (PBI), European Organization for Cancer Research and Treatment Life before and after treatment Quality of Life Scale (EORTC-QLQ-30), Breast Cancer Specific Quality of Life Scale (EORTCQLQ-BR-23) and Short Form 36 (SF-36) were applied. Results: The post-treatment score of LLIS, Lymph-ICF, LYMPQOL and EORTCQLQ-BR23 (excluding sexual function and pleasure) was found to be significantly higher than before (p<0.0001). Significant difference was determined in SF-36 posttreatment scores compared to before (except healthchange). For those whose total score could be calculated, two outcome measures showed the largest effect size: LYMQOL (d=-0.88; SRM=-0.38; GI=-0.36), VAS tension (d=0.88; SRM=0.4; GI=0.7). For those whose total score could not be calculated, three outcome measures showed the greatest effect size: EORTC-QLQ-BR23 arm-related problems, hair loss anxiety, and systemic treatment side effects (d=1.35; SRM=0.46; GI=0.41), (d=1.15; SRM=0.47; GI=0.44), (d=1.10; SRM= 0.47; GI=0.43). Conclusion: LYMQOL and VAS strain; The EORTC-QLQ-BR23 arm-related problems, hair loss anxiety and systemic treatment side effects subscales, among the scales whose total score cannot be calculated, are the most responsive end-state criteria in breast cancer-related lymphedema. Keywords: Lymphedema, breast cancer, responsiveness, scale