Research Tessa De Vrieze

Abstract

If left untreated, breast edema can lead to decreased quality of life, body image issues, and fear of cancer reoccurrence, as well as continued breast discomfort and pain. Wearing a sports bra or compression bra is mentioned as an important factor within the treatment of breast oedema, but this is currently not reimbursed by the healthcare system in Belgium. Another treatment modality aimed at improving the lymphatic fluid uptake, is the application of kinesio tape. Kinesio tape has been used for many years in the treatment of sports injuries. More recently, it has also been used by oedema therapists in clinical practice to reduce local swelling and pain and improve muscle activity. Little evidence is available regarding the effect of kinesio tape in patients with breast-cancer related lymphoedema at the arm. The tape is believed to facilitate myofascial 'release' and increase the reabsorption of lymph into underlying tissues. After an initial application of the tape by a therapist, during which the tape is tested, the patient can be taught to apply and remove the tape independently. In most breast cancer patients who underwent breast conserving surgery and radiotherapy, epidermal thickness usually peaks at 4 to 6 months post-treatment and shows signs of returning to baseline, 12 months post-treatment. In contrast to transient breast edema, which declines spontaneously within 6 months after end of radiotherapy, in persistent or chronic breast oedema the symptoms remain for more than 6 months post-radiation. Patients with persistent breast oedema are advised to get appropriate treatment. The focus of the current research proposal is based on this population of patients. Therefore, the aim of this project is to investigate, in women with persistent breast and/or trunk oedema, whether application of kinesio tape is effective in 1) reducing pain and symptoms, 2) decreasing swelling and 3) improving quality of life. In addition, costs related to standard therapy as well as the addition of kinesio tape will be inventoried during the intervention period and follow-up.

Researcher(s)

• Promoter: De Vrieze Tessa
• Co-promoter: Gebruers Nick

Research team(s)

• Movement Antwerp (MOVANT)

Project type(s)

• Research Project

Abstract

Breast cancer related lymphedema or BCRL is due to its chronicity and impact an extremely dreaded complication after breast cancer treatment. The prevalence rate of objective BCRL is declining due to the major shift into the treatment approach of breast cancer. However, prevalence rate of subjective BCRL is much higher than that of objective BCRL. Subjective BCRL is defined as the diagnosis of BCRL based on the patient's sensation of a difference in size at the arm and/or trunk without any objectively measurable swelling. At this moment, it is not clear how many breast cancer patients experience subjective BCRL and what the underlying mechanisms may be. We hypothesize that four mechanisms might be associated with the presence and the severity of subjective BCRL, including sensory processing problems (1. nociceptive and/or 2. neuropathic and/or 3. central) and the presence of disturbed lymphatic transport without clinical manifestation (4. subclinical BCRL). To understand who and why patients after breast cancer treatment report subjective BCRL, a multi-center longitudinal study will be performed. This will be the first study investigating in 230 breast cancer patients the prevalence rate and underlying mechanisms of subjective BCRL at different time points (starting pre-surgery up to 6 months post-radiotherapy), using state-of-the art and innovative assessment methods for both different types of BCRL and their underlying mechanisms.

Researcher(s)

• Promoter: De Groef An
• Co-promoter: De Vrieze Tessa

Research team(s)

• Movement Antwerp (MOVANT)

Project type(s)

• Research Project

Abstract

Lymphedema is a chronic, debilitating disorder characterized by abnormal tissue swelling, adipose deposition and/or tissue fibrosis. Advances in oncologic treatment have led to an ever-increasing number of cancer survivors over time. As a result, morbidities related to the treatment (such as lymphedema) are likely to increase too. In the scientific community there is a large discrepancy in the reporting of incidence and prevalence data of lower limb lymphedema (LLL), because of a lack of valid and standardized measurement tools. It is unknown, at present, which measurement methods are the most accurate to use for screening, diagnosing or evaluating LLL in clinical practice. Consequently, at this moment there is an urgent need to validate the currently limited guidelines regarding screening, diagnosing (including severity grading) and evaluating unilateral and bilateral LLL and make them more concrete and unambiguous. To meet these needs, and to encourage an international uniformity regarding the management of LLL, the proposed project aims at developing a screening, diagnostic and evaluation set for patients with unilateral or bilateral LLL that can be used in clinical practice, based on directly edema-related measurement tools. Importantly, these sets need to be used in addition to questionnaires assessing problems or limitations in mental, social and general daily functioning as well as quality of life, in order to be able to outline a holistic treatment approach.

Researcher(s)

• Promoter: Meeus Mira
• Fellow: De Vrieze Tessa

Research team(s)

• Movement Antwerp (MOVANT)

Project type(s)

• Research Project