BACKGROUND: Except for lymphedema, the consequences of arm/shoulder problems (ASPs), at long-term in breast cancer survivors (BCSs) have hardly been studied. We examined demography, lifestyle, quality of life (QoL) and somatic morbidity in BCSs with and without ASPs. We also compared the associations of restricted shoulder abduction and lymphedema with QoL. METHODS: We used a cross-sectional case-control design. A sample of 256 BCSs all with lymph node metastases were examined at a mean of 4.1 (SD 0.9) years post-surgery. Based on objective examinations and self-rating the sample were separated into 81 BCSs (32%) with definite ASP (ASP+ group) and 175 (68%) with minimal or no ASP (ASP- group). The self-rating contained among other schedules the Short Form-36 (SF-36) and the Kwan's arm/shoulder problem scale (KAPS). RESULTS: In univariate analysis ASP+ was associated with not being employed, having had mastectomy, longer follow-up time, radiotherapy to axilla, poorer self-rated health and physical condition, minimal physical activity, increased body mass index, regularly intake of analgesics, and poorer physical QoL. Multivariate analysis showed that mastectomy, longer follow-up time, minimal physical activity and poorer physical QoL were associated with belonging to ASP+ group. All domains of the SF-36 were significantly associated with having impaired shoulder abduction (> or = 25 degrees difference) while none of the associations with lymphedema were significant. DISCUSSION: In BCSs, at four years after treatment, having ASP was associated with mastectomy, minimal physical activity and poorer physical QoL. Poor physical QoL is strongly associated with reduced shoulder abduction rather than with lymphedema.
BACKGROUND: Except for lymphedema, the consequences of arm/shoulder problems (ASPs), at long-term in breast cancer survivors (BCSs) have hardly been studied. We examined demography, lifestyle, quality of life (QoL) and somatic morbidity in BCSs with and without ASPs. We also compared the associations of restricted shoulder abduction and lymphedema with QoL. METHODS: We used a cross-sectional case-control design. A sample of 256 BCSs all with lymph node metastases were examined at a mean of 4.1 (SD 0.9) years post-surgery. Based on objective examinations and self-rating the sample were separated into 81 BCSs (32%) with definite ASP (ASP+ group) and 175 (68%) with minimal or no ASP (ASP- group). The self-rating contained among other schedules the Short Form-36 (SF-36) and the Kwan's arm/shoulder problem scale (KAPS). RESULTS: In univariate analysis ASP+ was associated with not being employed, having had mastectomy, longer follow-up time, radiotherapy to axilla, poorer self-rated health and physical condition, minimal physical activity, increased body mass index, regularly intake of analgesics, and poorer physical QoL. Multivariate analysis showed that mastectomy, longer follow-up time, minimal physical activity and poorer physical QoL were associated with belonging to ASP+ group. All domains of the SF-36 were significantly associated with having impaired shoulder abduction (> or = 25 degrees difference) while none of the associations with lymphedema were significant. DISCUSSION: In BCSs, at four years after treatment, having ASP was associated with mastectomy, minimal physical activity and poorer physical QoL. Poor physical QoL is strongly associated with reduced shoulder abduction rather than with lymphedema.
Authors: Renate M Winkels; Kathleen M Sturgeon; Michael J Kallan; Lorraine T Dean; Zi Zhang; Margaret Evangelisti; Justin C Brown; David B Sarwer; Andrea B Troxel; Crystal Denlinger; Monica Laudermilk; Anna Fornash; Angela DeMichele; Lewis A Chodosh; Kathryn H Schmitz Journal: Contemp Clin Trials Date: 2017-07-21 Impact factor: 2.226
Authors: Seoyon Yang; Dae Hwan Park; Sei Hyun Ahn; Jisun Kim; Jong Won Lee; Jun Young Han; Dong Kyu Kim; Jae Yong Jeon; Kyoung Hyo Choi; Won Kim Journal: Support Care Cancer Date: 2016-12-09 Impact factor: 3.603
Authors: P Farace; M A Deidda; I Iamundo de Cumis; I Iamundo de Curtis; E Deiana; R Farigu; G Lay; S Porru Journal: Strahlenther Onkol Date: 2013-10-10 Impact factor: 3.621
Authors: Jacek A Kopec; Linda H Colangelo; Stephanie R Land; Thomas B Julian; Ann M Brown; Stewart J Anderson; David N Krag; Takamaru Ashikaga; Joseph P Costatino; Norman Wolmark; Patricia A Ganz Journal: J Support Oncol Date: 2013-03