Validation of the FACT-B+4-UL questionnaire and exploration of its predictive value in women submitted to surgery for breast cancer

Abstract

Introduction and objective

The early detection of upper limb complications is important in women operated on for breast cancer. The “FACT-B+4-UL” questionnaire, a specific variant of the Functional Assessment of Cancer Therapy-Breast (FACT-B) is available among others to measure the upper limb function.

Patients and methods

The Spanish version of the upper limb subscale of the FACT-B+4 was validated in a prospective cohort of 201 women operated on for breast cancer (factor analysis, internal consistency, test–retest reliability, construct validity and sensitivity to change were determined). Its predictive capacity of subsequent lymphoedema and other complications in the upper limb was explored using logistic regression.

Results

This subscale is unifactorial and has a great internal consistency (Cronbach's alpha: 0.87), its test–retest reliability and construct validity are strong (intraclass correlation coefficient: 0.986; Pearson's R with “Quick DASH”: 0.81) as is its sensitivity to change. It didn’t predict the onset of lymphedema. Its predictive capacity for other upper limb complications is low.

Conclusions

FACT-B+4-UL is useful in measuring upper limb disability in women surgically treated for breast cancer; but it does not predict the onset of lymphoedema and its predictive capacity for others complications in the upper limb is low.

Resumen

Introducción y objetivo

La detección precoz de las complicaciones del miembro superior en mujeres intervenidas de cáncer de mama es importante. El cuestionario FACT-B+4-MS, variante del Functional Assessment of Cancer Therapy-Breast (FACT-B) es una escala específica de la función del miembro superior en estas pacientes.

Pacientes y métodos

Se valida el FACT-B+4-MS en una cohorte prospectiva de 201 mujeres intervenidas por cáncer de mama (análisis factorial, consistencia interna, fiabilidad test-retest, validez del constructo y sensibilidad al cambio) y se explora mediante regresión logística su capacidad predictora de linfedema y otras complicaciones.

Resultados

El FACT-B+4-MS es unifactorial y goza de gran consistencia interna (alfa de Cronbach: 0,87), alta fiabilidad test-retest (coeficiente de correlación intraclase: 0,98), validez de constructo (R de Pearson con el “Quick DASH”: 0,81) y sensibilidad al cambio. En los modelos de regresión, no aparece como variable explicatoria de linfedema, pero sí de otras complicaciones del miembro superior.

Conclusiones

El FACT-B+4-MS es útil para medir la discapacidad del miembro superior en mujeres operadas por cáncer de mama. No predice el establecimiento de linfedema, pero sí, aunque débilmente, otras alteraciones.