Late morbidity in upper limb function and quality of life in women after breast cancer surgery (original) (raw)
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Tumori
Breast cancer is the second most common malignancy among women. Surgical and supplemental (or adjuvant) therapies to combat the disease may implicate physical functional consequences for the ipsilateral upper extremity. These dysfunctions may persist for many years and have repercussions on the performance of daily living activities. The aim of this study was to assess the impact of physical functional disabilities on quality of life in women after breast cancer surgery. Eighty-two women in the postoperative period of conservative surgery for breast cancer participated in the study. Axillary lymph node dissection was performed in all patients and mean time since surgery was 5.78 (± 4.60) years. The women responded to a questionnaire to assess quality of life (FACT-B) and to another to assess functional capacity (QuickDASH). They were then referred to physical therapy examination to measure shoulder range of motion (flexion, abduction and external rotation) and arm volume. Range of m...
Brazilian Journal of Health Review, 2021
Introduction: Breast is cancer is the most common cancer in women, and the various procedures and treatments performed after diagnosis can trigger physical symptoms. The objective was to verify the influence of pain on the functionality of the upper limbs (UL) in women after breast cancer surgery, in two postoperative periods. Methods: This is an exploratory cross-sectional study with women evaluated postoperatively at 6 (N=126) and 12 months (N=74). The outcomes were assessed using a Pain Body Diagram, a Numerical Pain Scale, and Quick-DASH. Multiple linear hierarchical regression analysis was performed adjusting for pain, clinical (radiotherapy, chemotherapy and axillary intervention), and sociodemographic variables (age, education level, ethnic), p <0.05. Results: Participants in the 6-month group had a similar functionality score (mean=27, SD=18.9) compared to the 12-month group (mean=24.6, SD=19.1). In both postoperative periods, the intensity of pain was classified as moderate, and the anterior region of the trunk was the most affected. Pain was more prevalent at 6 months (71.4%) compared to 12 months PO (57.3%), but the intensity of pain in the anterior and lateral trunk for the 12 months PO group was significantly higher compared to those at 6 months PO (p<.05). Among the variables included in the model, only pain was associated with worse functionality scores both at 6 (R²=0.23) and at 12 months postoperatively (R²=0.31). Conclusion: Pain was the most important factor influencing upper limb functionality. These results can guide professionals to foster pain control strategies to improve upper limb functionality.
Oncology Section Task Force on Breast Cancer Outcomes: Clinical Measures of Upper Extremity Function
Rehabilitation Oncology
is the official publication of the Oncology Section, APTA. Copyright 2013 by the Oncology Section, APTA. Nonmember and institution subscriptions are available for 70peryear(4issues).Backissuesareavailableformembers(70 per year (4 issues). Back issues are available for members (70peryear(4issues).Backissuesareavailableformembers(5) and nonmembers ($20). The contents of articles appearing in this publication represent the thoughts and ideas of the authors and do not necessarily reflect the views of the Oncology Section, APTA. The editor reserves the right to edit submitted manuscripts or other material as necessary for publication. We encourage comments and opinions concerning the content of Rehabilitation Oncology through Letters to the Editor.
Comparison of Upper Extremity Function in Women With and Women Without a History of Breast Cancer
Physical Therapy, 2020
Background Breast cancer treatments often result in upper extremity functional limitations in both the short and long term. Current evidence makes comparisons against a baseline or contralateral limb, but does not consider changes in function associated with aging. Objective The objective of this study was to compare upper extremity function between women treated for breast cancer more than 12 months in the past and women without cancer. Design This was an observational cross-sectional study. Methods Women who were diagnosed with breast cancer and had a mean post–surgical treatment time of 51 months (range = 12–336 months) were compared with women who did not have breast cancer (CTRL group). Self-reported upper extremity function using the Disabilities of the Arm, Shoulder and Hand (DASH) questionnaire and shoulder range of motion, strength, and muscular endurance were measured. Participants were divided into 3 groups: breast cancer involving the nondominant limb (BC-ND), breast can...
Journal of Surgical Oncology, 2010
Background and Objectives: To investigate the prevalence of upper limb dysfunction (ULD) and subtypes after breast cancer surgery and to identify factors associated with late ULD. Methods: Among 191 enrolled patients, 191 were evaluated at 3 months, 187 at 6 months, and 183 at 12 months after surgery. Pain, shoulder range of motion, muscle strength, and arm circumference were assessed. Based on symptoms and physical examinations, the types of ULD common after breast cancer treatment were diagnosed and categorized. Results: The prevalence of ULD after surgery were 24.6%, 20.9%, and 26.8% at 3, 6, and 12 months, respectively. The most common types of ULD were pectoralis tightness at 3 and 6 months and lymphedema at 12 months. Patients with pectoralis tightness or lymphedema at 3 or 6 months showed a higher prevalence of rotator cuff disease at 12 months compared with those without early pectoralis tightness or lymphedema. Conclusions: The major post-operative ULD were pectoralis tightness at 3 and 6 months and lymphedema at 12 months. Late ULD such as rotator cuff disease were associated with pectoral tightness or lymphedema at earlier stages. Diagnosis and treatment of ULD should take place as soon as possible after surgery.
Brazilian Journal of Development
Purpose: To map pain frequency and pain intensity according to activities in the physical domain of the Disabilities of the Arm, Shoulder and Hand Questionnaire (DASH), at three, six and nine months after breast cancer surgery. In addition, to verify the correlation between upper limb function and pain intensity. Methods: This is a prospective cohort study, with follow-up at three time points. 22 Brazilian women diagnosed with breast cancer were included at three months after breast surgery. They performed the DASH questionnaire, the Body Pain Diagram and the Visual Analogue Scale. Frequency measures were used to analyze the frequency and intensity of pain in the items of the physical domain of the DASH. Pearson's correlation coefficient between pain intensity and the DASH total score at the three different times was calculated, a 95% confidence interval was set. Results: For twenty-two women at three, six and nine months after surgery, the body area with the highest pain freque...
European Journal of Surgical Oncology (EJSO), 2003
Aims: Breast cancer treatment may result in long-term upper limb morbidity: reduced range of motion of the shoulder, muscle weakness of the arm and hand, lymph edema, pain and numbness. Relationship of this late morbidity with activities of daily life (ADL) and quality of life (QOL) is infrequently described and the strength of this relationship is not clear. Methods: A systematic review was performed to evaluate the results of studies, analyzing late morbidity of breast cancer treatment in relationship with ADL and/or QOL. A literature search over the last 20 years (1980±2000) was performed in the databases MEDLINE, EMBASE, PSYCHLIT and CANCERLIT. Methodological quality of selected articles was assessed and additional, aspects of treatment related late morbidity and the relationship to ADL and/or QOL were summarized. Results: From the 1642 yielded articles 15 fulfilled our primary selection criteria. Only six articles could be selected due to the inappropriate methodological quality. There was high variation in prevalence of pain (12±51%), impairments in range of motion (2±51%), edema (6±43%) and decreased muscle strength (17±33%). Four articles reported significant relationships between late morbidity of the upper limb and perceived disabilities in ADL/QOL. The strength of these relationships was rather low. Conclusions: Few studies investigated the relationship between late morbidity of the upper limb after treatment of early breast cancer and ADL/QOL. Significant relationship between late morbidity and restrictions of daily activities and poorer QOL was reported, however, the strength of this relationship was rather low.
Journal of Rehabilitation Medicine, 2004
Objective: To describe the impairments of upper body and limbs, activity limitations and participation restrictions 6 and 12 months after operation for breast cancer and to examine the impact of impairments on activity limitations. Design: A prospective survey 6 and 12 months after operation. Patients: Ninety-six breast cancer patients. Methods: A questionnaire for assessing the impairments, activity limitations and participation restrictions was developed. Results: The most common impairments 6 months after operation were breast and axilla scar tightness, axilla oedema and neck-shoulder pain. At 12-month follow-up the breast scar tightness ( p = 0.008) and axilla oedema ( p = 0.023) decreased, and limb ache ( p = 0.005) increased significantly. The most limiting impairments were axilla oedema and limb numbness 6 months after operation, and at 12-month follow-up axilla oedema. Lifting, carrying and reaching out caused worsening of impairments to more than half of the respondents at 6-month follow-up. Regression analysis showed that many impairments together were determinants of activity limitations and sleep impairment. Participation restrictions were constant. Respondents had not given up participation in activities in the home, but some had abandoned leisure activities and felt that their work ability had decreased. Conclusion: Impairments and their impact on activities were frequent and constant. There is an urgent need for developing rehabilitation protocols for breast cancer patients.
BMC Cancer, 2021
Background Breast cancer surgery frequently causes deficiencies in shoulder functioning. The study pourpode is to identify risk factors for prolonged pain, reduction in function, and decrease in range of motion (ROM) in BC patients. Methods A prospective cohort study was designed in a private hospital; between October 2018 and April 2019 with a follow-up of 6 months. Patients following BC surgery, were divided by arm morbidities, and the different risk facrors were evaluated using univariate analysis and logistic regression. Results A total of 157 patients were included in the study. Risk factors for functional disabilities included; pain levels during hospitalization NPRS 1.2 (±0.8) compared to patients with no disabilities 0.5 ± 0.7 (p = .006), the size of tumors more than 1.4 ± 0.8 cm. compared with no morbidities 0.8 ± 0.9 cm. (p = .046), and breast reconstructions (p = .030). Risk factors for prolonged pain includes mastectomy (p = .006), breast reconstruction (p = .011), more ...