Purpose To determine the relationship between physical methods of measuring lymphedema and self-reported swelling, their reliability, and standard error of measurement. Method: Lymphedema in each arm of women with (n = 33) and without (n = 18) unilateral arm lymphedema, secondary to breast cancer was measured by self-report, bioimpedance spectroscopy (BIS), perometer, and the truncated cone method. Results: The physical measurement tools were highly reliable (ICC_(2,1): 0.94 to 1.00) with high concordance (r_c: 0.89 to 0.99). Selfreport correlatedmoderately with physical measurements (r = 0.65 to 0.71) and was moderately reliable (ICC_(2,1): 0.70). Conclusions: Lymphedema assessment methods are concordant and reliable but not interchangeable.

Outcomes have improved significantly for many women diagnosed with breast cancer. For the heterogeneous group of tumours lacking expression of the oestrogen, progesterone and HER2 receptors, ‘triple negative’ breast cancers (TNBC), the prognosis overall has remained quite poor. When TNBC recurs, there is often little response to chemotherapy, and there are a few treatment options in this setting. Thus, there is an urgent clinical need to identify new therapeutic targets in order to improve the outlook for these patients. This review highlights the most promising therapeutic targets identified through new sequencing technologies, as well as through studies of apoptosis. We also present mounting evidence that the developmental signalling pathways Wnt/β-catenin, NOTCH and Hedgehog play an important role in the pathogenesis and progression of TNBC with new therapeutic approaches inhibiting these pathways in advanced preclinical studies or early clinical trials.

Background: Shoulder movement impairment is a commonly reported consequence of surgery for breast cancer.Objective: The aim of this study was to determine whether shoulder girdle kinematics, including those of the scapula, spine, and upper limb, in women who have undergone a unilateral mastectomy for breast cancer are different from those demonstrated by an age-matched control group.Design: An observational study using 3-dimensional kinematic analysis was performed.Methods: Women who had a unilateral mastectomy on their dominant-arm side (n=29, mean [±SD] age=62.4±8.9 years) or nondominant-arm side (n=24, mean [±SD] age=59.8±9.9 years), as well as a control group of age-matched women without upper-limb, shoulder, or spinal problems (n=22, mean [±SD] age=58.1±11.5 years), were measured while performing bilateral arm movements in the sagittal, scapular, and coronal planes. All of the women were free of shoulder pain at the time of testing. Data were collected from the glenohumeral joint, the scapulothoracic articulation, and the spine (upper and lower thoracic and lumbar regions) using an electromagnetic tracking system.Results: Women following mastectomy displayed altered patterns of scapular rotation compared with controls in all planes of movement. In particular, the scapula on the mastectomy side rotated upward to a markedly greater extent than that on the nonmastectomy side, and women following mastectomy displayed greater scapular excursion than controls.Conclusions: The findings suggest that altered motor patterns of the scapula are associated with mastectomy on the same side. Whether these changes are harmful or not is unclear. Investigation of interventions designed to restore normal scapulohumeral relationships on the affected side following unilateral mastectomy for breast cancer is warranted.