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Development and clinimetric properties of the Dutch Breast Edema Questionnaire (BrEQ-Dutch version) to diagnose the presence of breast edema in breast cancer patients

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Abstract

Purpose

To develop a diagnostic tool, the Breast Edema Questionnaire (BrEQ) and to determine its clinimetric properties.

Methods

The BrEQ was developed based on information from literature, experts and breast edema patients. Content validity, construct validity, test–retest reliability, internal consistency and cut-off point were investigated in a group of breast cancer patients. Construct validity made up two parts; convergent and known-groups validity. Convergent validity was tested by correlating the BrEQ with skin thickness measured with ultrasound (US).

Results

In part 1 of the BrEQ, symptoms of breast edema were scored from 0 to 10: pain, heaviness, swelling, tensed skin, redness, pitting sign, enlarged skin pores and hardness. Taking into account the International Classification of Functioning, Disability and Health, several activity limitations and participation restrictions were scored from 0 to 10 in part 2. Clinimetric properties of part 1 were examined in 55 patients. US showed that 35 women had breast edema. Content validity was good. Regarding convergent validity, all breast symptoms correlated moderately with skin thickness. The total symptom score had a strong correlation with skin thickness. Concerning known-groups validity, patients with breast edema had a higher total symptom score. Test–retest reliability ranged between moderate and strong. The internal consistency was good for all items and the total symptom score. We identified that a score cut-off point of ≥ 8.5 discriminates between patients with breast edema and those without.

Conclusion

Part 1 of the BrEQ-Dutch version is a valid and reliable tool for assessing clinical indicators of breast edema.

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Acknowledgements

The authors would like to acknowledge Nele Van Dooren en Evi Moeyersoms for their assistance in patient recruitment and data collection.

Funding

Funding was provided by Vlaamse regering (Grant No. G078).

Author information

Author notes

  1. Wiebren Tjalma and Nick Gebruers shared last author.

Authors and Affiliations

  1. Department of Rehabilitation Sciences and Physiotherapy, Faculty of Medicine and Health Sciences, University of Antwerp, Universiteitsplein 1, 2610, Antwerp, Belgium

    Hanne Verbelen, Tessa De Vrieze, Timia Van Soom, Jill Meirte & Nick Gebruers

  2. Department of Rehabilitation Sciences, KU Leuven, University of Leuven, Tervuursevest 101, 3001, Louvain, Belgium

    Tessa De Vrieze

  3. Faculty of Medicine and Health Sciences, University of Antwerp, Universiteitsplein 1, 2610, Antwerp, Belgium

    Mireille Van Goethem & Wiebren Tjalma

  4. Department of Radiology, Antwerp University Hospital (UZA), Wilrijkstraat 10, 2650, Edegem, Belgium

    Mireille Van Goethem & Godelieve Hufkens

  5. Multidisciplinary Breast Clinic Antwerp, Antwerp University Hospital (UZA), Wilrijkstraat 10, 2650, Edegem, Belgium

    Wiebren Tjalma

  6. Oedema Clinic, Antwerp University Hospital and University of Antwerp, Drie Eikenstraat 655, 2650, Edegem, Belgium

    Wiebren Tjalma & Nick Gebruers

Authors
  1. Hanne Verbelen
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  2. Tessa De Vrieze
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  4. Jill Meirte
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  7. Wiebren Tjalma
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  8. Nick Gebruers
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Contributions

All authors contributed to the study conception and design. Material preparation, data collection and analysis were performed by HV, TV, TS, JM, MG, GH, WT and NG. The first draft of the manuscript was written by HV and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Nick Gebruers.

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Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. The study was approved by the Ethical Committee of the Antwerp University Hospital (registration: B300201317503).

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Verbelen, H., De Vrieze, T., Van Soom, T. et al. Development and clinimetric properties of the Dutch Breast Edema Questionnaire (BrEQ-Dutch version) to diagnose the presence of breast edema in breast cancer patients. Qual Life Res 29, 569–578 (2020). https://doi.org/10.1007/s11136-019-02337-z

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