{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T16:45:14Z","timestamp":1787849114301,"version":"build-2784847793"},"reference-count":60,"publisher":"MDPI AG","issue":"5","license":[{"start":{"date-parts":[[2022,2,22]],"date-time":"2022-02-22T00:00:00Z","timestamp":1645488000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"UNIPEQ Sdn. Bhd.","award":["NN-2020-087"],"award-info":[{"award-number":["NN-2020-087"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJERPH"],"abstract":"<jats:p>Backgrounds: Assessing quality of life (QoL) using a well-developed and validated questionnaire is an essential part of a breast cancer-related lymphedema (BCRL) treatment. However, a QoL questionnaire with the best psychometric properties is so far unknown. The aim of this systematic review is to evaluate the psychometric properties of the questionnaires measuring the QoL of patients with BCRL. Methods: A thorough search was performed to identify published studies in electronic databases such as Medline (via Ovid), EBSCOhost, PubMed, Scopus, and Web of Science, on 8 February 2022, by using search terms as follows: \u2018quality of life\u2019; \u2018breast cancer\u2019; \u2018upper limb\u2019; \u2018lymphedema\u2019; \u2018questionnaire\u2019; and \u2018measurement properties.\u2019 Two reviewers conducted article selection, data extraction, and quality assessment independently. The third reviewer helped solve any possible disagreements between the two reviewers. The COSMIN checklist and manual were used to assess the quality of included studies. Results: A total of nineteen articles with nine questionnaires were included and assessed using the COSMIN Risk of Bias checklist. Most studies only assessed content validity, structural validity, internal consistency, reliability, and construct validity. Lymph-ICF-UL showed the most \u2018sufficient\u2019 and \u2018high\u2019 quality of evidence ratings for its measurement properties. Conclusion: The most appropriate questionnaire for use based on our assessment is Lymph-ICF-UL.<\/jats:p>","DOI":"10.3390\/ijerph19052519","type":"journal-article","created":{"date-parts":[[2022,2,22]],"date-time":"2022-02-22T22:34:30Z","timestamp":1645569270000},"page":"2519","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":14,"title":["Psychometric Properties of Quality of Life Questionnaires for Patients with Breast Cancer-Related Lymphedema: A Systematic Review"],"prefix":"10.3390","volume":"19","author":[{"given":"Estu","family":"Meilani","sequence":"first","affiliation":[{"name":"Physiotherapy Program, Center for Rehabilitation and Special Needs Studies, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur 50300, Malaysia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Asfarina","family":"Zanudin","sequence":"additional","affiliation":[{"name":"Physiotherapy Program, Center for Rehabilitation and Special Needs Studies, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur 50300, Malaysia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nor Azlin","family":"Mohd Nordin","sequence":"additional","affiliation":[{"name":"Physiotherapy Program, Center for Rehabilitation and Special Needs Studies, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur 50300, Malaysia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2022,2,22]]},"reference":[{"key":"ref_1","unstructured":"WHO (2018). Global Cancer Observatory: Cancer Today, WHO."},{"key":"ref_2","first-page":"101","article-title":"Quality of Care and Cancer Survivorship: The Challenge of Implementing the Institute of Medicine Recommendation","volume":"Volume 5","author":"Ganz","year":"2009","journal-title":"Cancer Quality Alliance Proceedings"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"CMO.S6389","DOI":"10.4137\/CMO.S6389","article-title":"Life after Breast Cancer: Dealing with Lymphoedema","volume":"5","author":"Perea","year":"2011","journal-title":"Clin. Med. Insights Oncol."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"81","DOI":"10.2147\/BCTT.S47012","article-title":"Methods to Improve Rehabilitation of Patients Following Breast Cancer Surgery: A Review of Systematic Reviews","volume":"7","author":"Loh","year":"2015","journal-title":"Breast Cancer Targets Ther."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"48","DOI":"10.7812\/TPP\/14-241","article-title":"Breast Cancer Survivorship: A Comprehensive Review of Long-Term Medical Issues and Lifestyle Recommendations","volume":"19","author":"Bodai","year":"2019","journal-title":"Perm. J."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"500","DOI":"10.1016\/S1470-2045(13)70076-7","article-title":"Incidence of Unilateral Arm Lymphoedema after Breast Cancer: A Systematic Review and Meta-Analysis","volume":"14","author":"DiSipio","year":"2013","journal-title":"Lancet Oncol."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"5138","DOI":"10.1002\/cncr.25458","article-title":"Lymphedema beyond Breast Cancer: A Systematic Review and Meta-Analysis of Cancer-Related Secondary Lymphedema","volume":"116","author":"Cormier","year":"2010","journal-title":"Cancer"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"147","DOI":"10.1196\/annals.1413.014","article-title":"Estimating the Population Burden of Lymphedema","volume":"1131","author":"Rockson","year":"2008","journal-title":"Ann. N. Y. Acad. Sci."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"775","DOI":"10.1158\/1055-9965.EPI-06-0168","article-title":"The Epidemiology of Arm and Hand Swelling in Premenopausal Breast Cancer Survivor","volume":"16","author":"Paskett","year":"2007","journal-title":"Cancer Epidemiol. Biomarkers Prev."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"521","DOI":"10.1097\/01.prs.0000297635.33874.a5","article-title":"Learning from a Liymphedema Clinic: An Algorithm for the Management of Localized Swelling","volume":"121","author":"Garfein","year":"2008","journal-title":"Plast. Reconstr. Surg."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"145","DOI":"10.1177\/1358836X9800300209","article-title":"Lymphedema: Classification, Diagnosis and Therapy","volume":"3","author":"Szuba","year":"1998","journal-title":"Vasc. Med."},{"key":"ref_12","first-page":"118","article-title":"Post-Breast Cancer Lymphedema: Incidence Increases from 12 to 30 to 60 Months","volume":"43","author":"Armer","year":"2010","journal-title":"Lymphology"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"49","DOI":"10.1007\/s10549-005-3781-2","article-title":"The Comparison of Two Different Physiotherapy Methods in Treatment of Lymphedema after Breast Surgery","volume":"93","author":"Didem","year":"2005","journal-title":"Breast Cancer Res. Treat."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"8","DOI":"10.3322\/caac.20001","article-title":"Lymphedema: A Primer on the Identification and Management of a Chronic Condition in Oncologic Treatment","volume":"59","author":"Lawenda","year":"2009","journal-title":"CA Cancer J. Clin."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"1209","DOI":"10.1016\/S0360-3016(02)04273-6","article-title":"Risk of Lymphedema after Regional Nodal Irradiation with Breast Conservation Surgery","volume":"55","author":"Coen","year":"2003","journal-title":"Int. J. Radiant. Oncol. Biol. Phys."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"69","DOI":"10.1016\/j.amjsurg.2002.12.003","article-title":"Lymphedema after Treatment of Breast Cancer","volume":"187","author":"Ozaslan","year":"2004","journal-title":"Am. J. Surg."},{"key":"ref_17","doi-asserted-by":"crossref","unstructured":"Yusof, K.M., Avery-Kiejda, K.A., Ahmad Suhaimi, S., Ahmad Zamri, N., Rusli, M.E.F., Mahmud, R., Saini, S.M., Abdul Wahhab Ibraheem, S., Abdullah, M., and Rosli, R. (2021). Assessment of Potential Risk Factors and Skin Ultrasound Presentation Associated with Breast Cancer-Related Lymphedema in Long-Term Breast Cancer Survivors. Diagnostics, 11.","DOI":"10.3390\/diagnostics11081303"},{"key":"ref_18","first-page":"381","article-title":"Prevention and Management of Arm Lymphedema in the Patient with Breast Cancer","volume":"4","author":"Golshan","year":"2006","journal-title":"J. Support. Oncol."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"226","DOI":"10.1016\/0885-3924(93)90132-F","article-title":"Psychiatric Consultation for Women Undergoing Rehabilitation for Upper-Extremity Lymphedema Following Breast Cancer Treatment","volume":"8","author":"Passik","year":"1993","journal-title":"J. Pain. Symptom. Manag."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"196","DOI":"10.1177\/136345930000400204","article-title":"Social Realities of Loss and Suffering Following Mastectomy","volume":"4","author":"Crouch","year":"2000","journal-title":"Health"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"83","DOI":"10.1007\/s11764-012-0247-5","article-title":"Quality of Life among Breast Cancer Patients with Lymphedema: A Systematic Review of Patient-Reported Outcome Instruments and Outcomes","volume":"7","author":"Pusic","year":"2013","journal-title":"J. Cancer Surviv."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"35","DOI":"10.1046\/j.1471-6712.2003.00119.x","article-title":"Breast Cancer Patients\u2019 Experiences of Lymphoedema","volume":"17","author":"Johansson","year":"2003","journal-title":"Scand. J. Caring Sci."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"851","DOI":"10.1093\/ptj\/85.9.851","article-title":"Comparison of 2 Quality-of-Life Questionnaires in Women Treated for Breast Cancer: The RAND 36-Item Health Survey and the Functional Living Index-Cancer","volume":"85","author":"Wilson","year":"2005","journal-title":"Phys. Ther."},{"key":"ref_24","first-page":"193","article-title":"Quality of Life and Body Image Impairments in Patients with Lymphedema","volume":"39","author":"Jaeger","year":"2006","journal-title":"Lymphology"},{"key":"ref_25","first-page":"185","article-title":"Disability, Psychological Distress, and Quality of Life in Breast Cancer Survivors with Arm Lymphedema","volume":"39","author":"Pyszel","year":"2006","journal-title":"Lymphology"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"f167","DOI":"10.1136\/bmj.f167","article-title":"Patient Reported Outcome Measures Could Help Transform Healthcare","volume":"346","author":"Black","year":"2013","journal-title":"BMJ"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"g7818","DOI":"10.1136\/bmj.g7818","article-title":"Patient Reported Outcome Measures in Practice","volume":"350","author":"Nelson","year":"2015","journal-title":"BMJ"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"1656","DOI":"10.1245\/s10434-020-09346-0","article-title":"Patient-Reported Outcome Measures in Lymphedema: A Systematic Review and COSMIN Analysis","volume":"28","author":"Beelen","year":"2021","journal-title":"Ann. Surg. Oncol."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"1147","DOI":"10.1007\/s11136-018-1798-3","article-title":"COSMIN Guideline for Systematic Reviews of Patient-Reported Outcome Measures","volume":"27","author":"Prinsen","year":"2018","journal-title":"Qual. Life Res."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"1171","DOI":"10.1007\/s11136-017-1765-4","article-title":"COSMIN Risk of Bias Checklist for Systematic Reviews of Patient-Reported Outcome Measures","volume":"27","author":"Mokkink","year":"2018","journal-title":"Qual. Life Res."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"339","DOI":"10.1007\/s11136-014-0785-6","article-title":"A Methodological Review of the Short Form Health Survey 36 (SF-36) and Its Derivatives among Breast Cancer Survivors","volume":"24","author":"Treanor","year":"2015","journal-title":"Qual. Life Res."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"134","DOI":"10.1089\/lrb.2017.0046","article-title":"Quality of Life Questionnaires in Breast Cancer-Related Lymphedema Patients: Review of the Literature","volume":"16","author":"Cornelissen","year":"2018","journal-title":"Lymphat. Res. Biol."},{"key":"ref_33","doi-asserted-by":"crossref","unstructured":"Meilani, E., Zanudin, A., and Nordin, N.A.M. (2020). Psychometric Properties of Quality of Life Questionnaires for Patients with Breast Cancer-Related Lymphedema: A Protocol for a Systematic Review. Medicine, 99.","DOI":"10.1097\/MD.0000000000023897"},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"1115","DOI":"10.1007\/s11136-009-9528-5","article-title":"Development of a Methodological PubMed Search Filter for Finding Studies on Measurement Properties of Measurement Instrument","volume":"18","author":"Terwee","year":"2009","journal-title":"Qual. Life Res."},{"key":"ref_35","unstructured":"Higgins, J., and Green, S. (2011). Cochrane Handbook for Systematic Reviews of Interventions Version 5.1.0 [Updated March 2011], The Cochrane Collaboration. Available online: https:\/\/crtha.iums.ac.ir\/files\/crtha\/files\/cochrane.pdf."},{"key":"ref_36","unstructured":"Deeks, J.J., Bossuyt, P.M. (2013). Cochrane Handbook for Systematic Reviews of Diagnostic Test Accuracy Reviews, The Cochrane Collaboration.. Available online: https:\/\/methods.cochrane.org\/sdt\/."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/2046-4053-4-1","article-title":"Preferred Reposrting Items for Systematic Review and Meta-Analysis (PRISMA) 2015 Statement","volume":"4","author":"Moher","year":"2015","journal-title":"Syst. Rev."},{"key":"ref_38","doi-asserted-by":"crossref","unstructured":"Eden, J., Levit, L., Berg, A., and Morton, S. (2011). Finding What Sorts in Health Care: Standards for Systematic Reviews, National Academic Press.","DOI":"10.17226\/13059"},{"key":"ref_39","unstructured":"Schunemann, H., Brozek, J., Guyatt, G., and Oxman, G. (2013). Handbook for Grading the Quality of Evidence and the Strength Recommendation Using GRADE Approach, Available online: https:\/\/gdt.gradepro.org\/app\/handbook\/handbook.html#h.z014s19g02b2."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"1159","DOI":"10.1007\/s11136-018-1829-0","article-title":"COSMIN Methodology for Evaluating the Content Validity of Patient-Reported Outcome Measures: A Delphi Study","volume":"27","author":"Terwee","year":"2018","journal-title":"Qual. Life Res."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"123","DOI":"10.5152\/ejbh.2017.3522","article-title":"Translation and Validation of the Turkish Version of Lymphedema Quality of Life Tool (LYMQOL) in Patients with Breast Cancer Related Lymphedema","volume":"13","author":"Bakar","year":"2017","journal-title":"Eur. J. Breast Health"},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"45","DOI":"10.1097\/NCC.0000000000000741","article-title":"Adaptation of Quality of Life Measure for Limb Lymphedema-Arm in Turkish Women with Breast Cancer-Related Lymphedema","volume":"44","author":"Karayurt","year":"2021","journal-title":"Cancer Nurs."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"205","DOI":"10.5606\/tftrd.2018.2843","article-title":"The Reliability and Validity of Lymphedema Quality of Life Questionnaire-Arm in Turkish Patients with Upper Limb Lymphedema Related with Breast Cancer","volume":"64","author":"Borman","year":"2018","journal-title":"Turk. J. Phys. Med. Rehabil."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"147","DOI":"10.5606\/tftrd.2019.3041","article-title":"Reliability and Validity of Turkish Version of Lymphedema Life Impact Scale","volume":"65","author":"Of","year":"2019","journal-title":"Turk. J. Phys. Med. Rehabil."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"132","DOI":"10.1186\/s12955-018-0958-z","article-title":"Psychometric Evaluation of the Persian Version of the Lymphedema Life Impact Scale (LLIS, Version 1) in Breast Cancer Patients","volume":"16","author":"Haghighat","year":"2018","journal-title":"Health Qual. Life Outcomes"},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"375","DOI":"10.1097\/NCC.0000000000000709","article-title":"The Reliability and Validity of the Turkish Version of the Lymphedema Life Impact Scale in Patients with Breast Cancer-Related Lymphedema","volume":"43","author":"Orhan","year":"2020","journal-title":"Cancer Nurs."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"563","DOI":"10.1111\/tbj.13620","article-title":"Psychometric Evaluation of the Arabic Version of the Lymphedema Life Impact Scale in Breast Cancer Patients","volume":"26","year":"2020","journal-title":"Breast J."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"944","DOI":"10.2522\/ptj.20100087","article-title":"Lymphoedema Functioning, Disability and Health Questionnaire (Lymph-ICF): Reliability and Validity","volume":"91","author":"Devoogdt","year":"2011","journal-title":"Phys. Ther."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"327","DOI":"10.1080\/09593985.2018.1443186","article-title":"The Danish Version of Lymphoedema Functioning, Disability and Health Questionnaire (Lymph-ICF) for Breast Cancer Survivors: Translation and Cultural Adaptation Followed by Validity and Reliability Testing","volume":"35","author":"Grarup","year":"2018","journal-title":"Physiother. Theory Pract."},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"347","DOI":"10.1089\/lrb.2018.0025","article-title":"Revision of the Lymphedema Functioning, Disability and Health Questionnaire for Upper Limb Lymphedema (Lymph-ICF-UL): Reliability and Validity","volume":"17","author":"Vos","year":"2019","journal-title":"Lymphat. Res. Biol."},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"365","DOI":"10.1089\/lrb.2019.0073","article-title":"Responsiveness of the Lymphedema Functioning, Disability, and Health Questionnaire for Upper Limb Lymphedema in Patients with Breast Cancer-Related Lymphedema","volume":"18","author":"Gebruers","year":"2020","journal-title":"Lymphat. Res. Biol."},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"2797","DOI":"10.1080\/09638288.2020.1716271","article-title":"Cross-Cultural Validation of the French Version of the Lymphedema Functioning, Disability and Health Questionnaire for Upper Limb Lymphedema (Lymph-ICF-UL)","volume":"43","author":"Frippiat","year":"2021","journal-title":"Disabil. Rehabil."},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"70","DOI":"10.1097\/NCC.0000000000000848","article-title":"Psychometric Validation of the Chinese Version of the Lymphedema Functioning, Disability, and Health Questionnaire for Upper Limb Lymphedema in Patients With Breast Cancer-Related Lymphedema","volume":"45","author":"Zhao","year":"2022","journal-title":"Cancer Nurs."},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"3103","DOI":"10.1007\/s00520-015-2684-y","article-title":"Development and Validation of the Lymphedema Symptom and Intensity Survey-Arm","volume":"23","author":"Ridner","year":"2015","journal-title":"Supportive Care Cancer"},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"428","DOI":"10.5606\/tftrd.2021.6228","article-title":"Validity and Reliability of the Turkish Version of the Lymphedema Symptom Intensity and Distress Survey","volume":"67","author":"Deveci","year":"2021","journal-title":"Turk. J. Phys. Med. Rehabil."},{"key":"ref_56","first-page":"131","article-title":"Upper Limb Lymphedema 27 (ULL27): Dutch Translation and Validation of an Illness-Specific Health-Related Quality of Life Questionnaire for Patients with Upper Limb Lymphedema","volume":"41","author":"Viehoff","year":"2008","journal-title":"Lymphology"},{"key":"ref_57","doi-asserted-by":"crossref","unstructured":"Kayali Vatansever, A., Yavuz\u015fen, T., and Karadibak, D. (2020). The Reliability and Validity of Quality of Life Questionnaire Upper Limb Lymphedema (ULL-27) Turkish Patient With Breast Cancer Related Lymphedema. Front. Oncol., 10.","DOI":"10.3389\/fonc.2020.00455"},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"61","DOI":"10.1016\/j.jclinepi.2018.04.014","article-title":"Psychometric Development of the Upper Limb Lymphedema Quality of Life Questionnaire Demonstrated the Patient-Reported Outcome Measure to Be a Robust Measure for Breast Cancer\u2013Related Lymphedema","volume":"100","author":"Williams","year":"2018","journal-title":"J. Clin. Epidemiol."},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"5166","DOI":"10.1245\/s10434-021-09887-y","article-title":"Development and Psychometric Validation of a Patient-Reported Outcome Measure for Arm Lymphedema: The LYMPH-Q Upper Extremity Module","volume":"28","author":"Klassen","year":"2021","journal-title":"Ann. Surg. Oncol."},{"key":"ref_60","unstructured":"WHO (2001). International Classification of Functioning, Disability, and Health: ICF, World Health Organization."}],"container-title":["International Journal of Environmental Research and Public Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1660-4601\/19\/5\/2519\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T22:24:47Z","timestamp":1760135087000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1660-4601\/19\/5\/2519"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,2,22]]},"references-count":60,"journal-issue":{"issue":"5","published-online":{"date-parts":[[2022,3]]}},"alternative-id":["ijerph19052519"],"URL":"https:\/\/doi.org\/10.3390\/ijerph19052519","relation":{},"ISSN":["1660-4601"],"issn-type":[{"value":"1660-4601","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,2,22]]}}}