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dc.contributor.authorSvensson-Florida, Brenda
dc.date.accessioned2019-06-17
dc.date.available2019-06-17
dc.date.issued2019-03-31
dc.identifier.urihttp://hdl.handle.net/2123/20577
dc.description.abstractProspective monitoring for onset of breast cancer-related lymphoedema (BCRL) following surgery for breast cancer may improve early detection and treatment outcomes. In situations in which prospective monitoring programs are not available or feasible, such as rural and remote areas, BCRL may not be detected until it is difficult to treat. This program of research investigated the capacity for patient self-assessment to inform BCRL detection. In the first study, a novel technique to detect mild and localised BCRL using bioimpedance spectroscopy (BIS) was undertaken using impedance measurements of four 10cm segments along the arm and hand (SEG-BIS). In the second study, SEG-BIS was tested against currently used whole arm BIS (ARM-BIS) thresholds in a group of women with a history of breast cancer and known BCRL status. The third study focused on the BIS instrumentation, evaluating potential sources of error and the impact of different electrodes on measurement. In the last study, a combination of SEG-BIS and ARM-BIS measurements were undertaken to determine associations between patient-reported symptoms and specific physical signs and BCRL presence. Determination of arm and hand SEG-BIS thresholds led to the development of two SEG-BIS detection criteria which detected BCRL without falsely identifying the condition. Patients accurately identified specific physical signs of BCRL in their arm. Patient-reported swelling and forearm tissue-pinch were highly associated with BIS-detected BCRL, with an absence of both identifying those who did not have the condition. A BCRL self-assessment (BCRL-SAS) tool incorporating swelling and forearm tissue-pinch is therefore proposed. Validation of the BCRL-SAS is required. If effective, this tool could inform patient decisions regarding the need or lack of need for lymphoedema assessment. This capacity may improve patient treatment burden and outcomes, particularly where prospective monitoring is not available.en_AU
dc.publisherUniversity of Sydneyen_AU
dc.publisherFaculty of Health Sciencesen_AU
dc.rightsThe author retains copyright of this thesis. It may only be used for the purposes of research and study. It must not be used for any other purposes and may not be transmitted or shared with others without prior permission.en_AU
dc.subjectLymphoedemaen_AU
dc.subjectBreast Canceren_AU
dc.subjectSelf-Assessmenten_AU
dc.subjectScreeningen_AU
dc.subjectBioimpedanceen_AU
dc.subject.otherincludes published articlesen_AU
dc.titleImproving detection of upper limb lymphoedemaen_AU
dc.typePhD Doctorateen_AU
dc.type.pubtypeDoctor of Philosophy Ph.D.en_AU
dc.description.disclaimerAccess is restricted to staff and students of the University of Sydney . UniKey credentials are required. Non university access may be obtained by visiting the University of Sydney Library.en_AU


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