This study presents the development process of the Arm Morbidity following Breast Cancer Treatments (ARM-BCT) tool.

A historical prospective study was conducted across five medical centers from 2020 to 2023. Medical information and a questionnaire covering morbidities, lifestyle, emotional state, and functioning were collected. Regression models analyzed 22 risk factors for chronic pain, lymphedema, functional limitations, and decreased range of motion. Significant factors were included in the ARM-BCT tool.

Seventeen significant risk factors were identified, including mastectomy (B = 2.073, CI, 7.403-5.366), axillary lymph node dissection (B = 0.194, CI, 0.988-1.036), breast reconstruction (B = 17.300, CI, 7.105-27.495), advanced stage (B = 0.498, CI, 1.044-2.594), chemotherapy (B = 1.326, CI, 0.870-3.673), BMI (B = 0.092, CI, 1.033-1.163), anxiety (B = 0.177, CI, 1.859-3.079), low physical activity levels (B = -0.059, CI, 0.190-0.001), specific comorbidities (B = -1.491, CI, 2.706-0.277), age (B = 0.035, OR = 1.036, CI, 1.002-1.071), and radiation therapy (B = 0.385, CI, 0.380-2.056), etc. The tool's development involved robust statistical modeling to determine the weight of each factor, evaluate model quality, and establish a clinically relevant cutoff point.

This article describes the development process of the ARM-BCT tool, designed to assess the risk of physical morbidity following breast cancer treatment. The tool incorporates 17 statistically significant risk and protective factors into a scoring scale ranging from 1 to 20. Risk is categorized as low (< 6) or high (> 7), enabling targeted recommendations for rehabilitation timing and necessity. While validation studies evaluating its clinical effectiveness are underway and will be presented in future publications, the ARM-BCT tool shows promise in enhancing recovery outcomes through early intervention.

The primary objective of this study was to assess and compare the response to the breast cancer-related lymphedema (BCRL) treatment with Breast Cancer-Related Lymphedema of the Upper Extremity (CLUE) scores, bioimpedance spectroscopy (BIS), and the volume-assessments /measurements. The secondary objective of the study was to investigate whether CLUE played a role in the treatment response and to examine its correlation with the other measures of lymphedema.

Between January 2019 and June 2019, a total of 40 patients (2 males, 38 females; mean age: 57.8±12.5 years; range, 45 to 70 years) who were diagnosed with unilateral Stage 2-3 BCRL and underwent treatment were included. The patients' upper extremity volumes were assessed and the patients were evaluated with the CLUE score, the Disabilities of the Arm, Shoulder, and Hand Outcome Measure (QuickDASH) score, BIS, and hand grip strength before and after the complete decongestive therapy.

Correlation analyses revealed that CLUE total score and BIS values were correlated with the reduction in the volumes (p=0.04 and p<0.001, respectively). The CLUE total score was also found to be positively correlated with the BIS values (p<0.001). Hand grip strength and QuickDASH scores were not found to be correlated with the changes in the volume and CLUE total scores.

The development of a structured clinical assessment such as CLUE provides clinicians for a standardized evaluation for BCRL. The diagnosis of subclinical lymphedema can be detected earlier by using the BIS and CLUE scale and lymphedema comorbidity and treatment costs can be reduced.

Background: Lymphaticovenular anastomosis (LVA) has recently become a mainstream surgical treatment for lymphedema and is a useful treatment option in addition to conservative therapies such as compression therapy, exercise therapy, and lymphatic drainage. We performed LVA with the goal of stopping compression therapy and report the effect of LVA on secondary lymphedema of the upper extremities. Methods and Results: The participants were 20 patients with secondary lymphedema of the upper extremities categorized as stage 2 or 3 according to the International Society of Lymphology classification. We measured and compared the upper limb circumference at six locations before and 6 months after LVA. Significant decreases in circumference after surgery were observed at 8 cm proximal to the elbow, the elbow joint, 5 cm distal to the elbow, and the wrist joints, but not at 2 cm distal to the axilla or the dorsum of the hand. At more than 6 months postoperatively, eight patients who had been wearing compression gloves were no longer required to wear them, and three patients who had been wearing both sleeves and gloves were no longer required to wear them. Conclusions: LVA is effective in the treatment of secondary lymphedema of the upper extremities, particularly in improving elbow circumference, and is one of the treatments that contributes significantly to the improvement of quality of life. For severe cases with limited range of motion of the elbow joint, LVA should be performed first. Based on these results, we present an algorithm for upper extremity lymphedema treatment.