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Inicio Medicina Clínica (English Edition) Validation of the FACT-B+4-UL questionnaire and exploration of its predictive va...
Journal Information
Vol. 148. Issue 12.
Pages 555-558 (June 2017)
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Vol. 148. Issue 12.
Pages 555-558 (June 2017)
Brief report
DOI: 10.1016/j.medcle.2017.05.015
Validation of the FACT-B+4-UL questionnaire and exploration of its predictive value in women submitted to surgery for breast cancer
Validación del cuestionario FACT-B+4-MS y exploración de su capacidad predictora en mujeres intervenidas de cáncer de mama
Juan Alfonso Andrade Ortegaa,
Corresponding author

Corresponding author.
, Ana Pilar Millán Gómeza, Marisa Ribeiro Gonzáleza, Pilar Martínez Piróa, Juan Jiménez Anulab, María Belén Sánchez Andújarb
a UGC de Aparato Locomotor, Servicio de Rehabilitación, Complejo Hospitalario de Jaén, Jaén, Spain
b Unidad de Cirugía de Mama, Complejo Hospitalario de Jaén, Jaén, Spain
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Tables (3)
Table 1. Values of FACT-B+4-UL, Cronbach's alpha and factor analysis 24h and 2 months after surgery.
Table 2. Variation of FACT-B+4-UL between one day and 2 months after surgery and patient's self-perceived difference regarding her upper limb.
Table 3. Logistic regression models to explain the occurrence of lymphedema and other upper limb abnormalities.
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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.


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.


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.

Disability evaluation
Breast cancer
Upper limb disorder
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.


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.


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.

Palabras clave:
Evaluación de la discapacidad
Cáncer de mama
Alteraciones del miembro superior


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