Anne Kuijer1,2,3, Laura S Dominici1,2,4, Shoshana M Rosenberg2,4,5, Jiani Hu6, Shari Gelber2, Simona Di Lascio4,5, Julia S Wong4,7, Kathryn J Ruddy8, Rulla M Tamimi9, Lidia Schapira10,11, Virginia F Borges12, Steven E Come4,13, Kim Sprunck-Harrild5, Ann H Partridge2,4,5, Tari A King14,15,16. 1. Division of Breast Surgery, Department of Surgery, Dana-Farber/Brigham and Women's Cancer Center, Boston, MA, USA. 2. Breast Oncology Program, Dana-Farber/Brigham and Women's Cancer Center, Boston, MA, USA. 3. Surgery, Antonius ziekenhuis, Nieuwegein, The Netherlands. 4. Harvard Medical School, Boston, MA, USA. 5. Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, USA. 6. Department of Data Sciences, Dana-Farber Cancer Institute, Boston, MA, USA. 7. Department of Radiation Oncology, Brigham and Women's Hospital, Dana-Farber Cancer Institute, Boston, MA, USA. 8. Medical Oncology, Mayo Clinic Rochester, Rochester, MN, USA. 9. Department of Population Health Sciences, Weill Cornell Medicine, New York, NY, USA. 10. Stanford Cancer Institute, Stanford, CA, USA. 11. Stanford University, Stanford, CA, USA. 12. Medical Oncology, University of Colorado Cancer Center, Denver, CO, USA. 13. Beth Israel Deaconess Medical Center, Boston, MA, USA. 14. Division of Breast Surgery, Department of Surgery, Dana-Farber/Brigham and Women's Cancer Center, Boston, MA, USA. tking7@bwh.harvard.edu. 15. Breast Oncology Program, Dana-Farber/Brigham and Women's Cancer Center, Boston, MA, USA. tking7@bwh.harvard.edu. 16. Harvard Medical School, Boston, MA, USA. tking7@bwh.harvard.edu.
Abstract
BACKGROUND: The impact of patient demographics and local therapy choice on arm morbidity in young breast cancer patients is understudied despite its importance given the long survivorship period. This study assessed patient-reported arm morbidity in the Young Women's Breast Cancer Study (YWS), a prospective cohort study. METHODS: From 2006 to 2016, 1302 women with breast cancer diagnosed at the age of 40 years or younger enrolled in the YWS. The participants regularly complete surveys. The response rates are higher than 86%. Using the Breast Cancer Prevention Trial Checklist, this study examined the prevalence of patient-reported postoperative arm swelling and decreased range of motion (ROM) 1 year after diagnosis, stratified by local therapy strategy, in patients who had surgery for stages 1 to 3 disease. Logistic regression analysis was used to identify risk factors for arm morbidity. RESULTS: Among 888 eligible participants (median age, 37 years), 14% reported arm swelling and 34% reported decreased ROM at 1 year. Arm swelling was reported by 23.6% of the patients who had axillary lymph node dissection (ALND) and 24.6% of the patients who received ALND and post-mastectomy radiation therapy (PMRT). In the multivariable analysis, the patients who reported being financially uncomfortable or who had ALND were at higher risk of arm swelling at 1 year. Being overweight, receiving ALND after sentinel lymph node biopsy, and receiving PMRT were associated with decreased ROM at 1 year. CONCLUSION: High rates of self-reported arm morbidity in young breast cancer survivors were reported, particularly in patients receiving ALND and PMRT. Attention to the risks and benefits of differing local therapy strategies for ALND and PMRT patients is warranted.
BACKGROUND: The impact of patient demographics and local therapy choice on arm morbidity in young breast cancerpatients is understudied despite its importance given the long survivorship period. This study assessed patient-reported arm morbidity in the Young Women's Breast Cancer Study (YWS), a prospective cohort study. METHODS: From 2006 to 2016, 1302 women with breast cancer diagnosed at the age of 40 years or younger enrolled in the YWS. The participants regularly complete surveys. The response rates are higher than 86%. Using the Breast Cancer Prevention Trial Checklist, this study examined the prevalence of patient-reported postoperative arm swelling and decreased range of motion (ROM) 1 year after diagnosis, stratified by local therapy strategy, in patients who had surgery for stages 1 to 3 disease. Logistic regression analysis was used to identify risk factors for arm morbidity. RESULTS: Among 888 eligible participants (median age, 37 years), 14% reported arm swelling and 34% reported decreased ROM at 1 year. Arm swelling was reported by 23.6% of the patients who had axillary lymph node dissection (ALND) and 24.6% of the patients who received ALND and post-mastectomy radiation therapy (PMRT). In the multivariable analysis, the patients who reported being financially uncomfortable or who had ALND were at higher risk of arm swelling at 1 year. Being overweight, receiving ALND after sentinel lymph node biopsy, and receiving PMRT were associated with decreased ROM at 1 year. CONCLUSION: High rates of self-reported arm morbidity in young breast cancer survivors were reported, particularly in patients receiving ALND and PMRT. Attention to the risks and benefits of differing local therapy strategies for ALND and PMRTpatients is warranted.
Authors: Jenna M Wilson; Carin A Colebaugh; K Mikayla Flowers; Robert R Edwards; Ann H Partridge; Laura S Dominici; Kristin L Schreiber Journal: Breast Cancer Res Treat Date: 2022-09-14 Impact factor: 4.624