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Lin H-F1, Tsauo J-Y2,3
1Devision of Physical Therapy, Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital, Taipei, Taiwan, 2School and Graduate Institute of Physical Therapy, College of Medicine, National Taiwan University, Taipei, Taiwan, 3Physical Therapy Center, National Taiwan University Hospital, Taipei, Taiwan
Background: As the result of breast cancer treatment, many patients suffer from serious complaints in their arm and shoulder, leading to limitations in activities of daily living and participation. Hence, to identify which arm/shoulder symptoms may contribute to upper extremity disability and reduced quality of life (QOL) is important for early physical therapy intervention.
Purpose: This study aimed (1) to investigate the prevalence of arm/shoulder symptoms after breast cancer surgery; (2) to determine the impact of arm/shoulder symptoms on upper extremity function and QOL; (3) to identify symptoms associated with upper extremity function and quality of life.
Methods: Cross-sectional survey and medical chart review were conducted to collect data including demographic, breast cancer related treatments, self-reported of 12 arm/shoulder complaints (pain, motion restriction, swelling and weakness). Participants were also fulfilled the questionnaires Disabilities of the arm, shoulder, and hand (DASH) which represented limitation of activity and participation in upper extremity, and the European Organization for Research and Treatment of Cancer (EORTC QLQ C-30) questionnaire for QOL.
Results: A total of 249 women post-breast cancer surgery (ranged from 2 weeks to 27 years) participated in this study. Among them, 82% participants reported at least one arm/shoulder symptom, and with mean 4.5±3.6 symptoms. Pain was the most common symptom (38%~46% in chest/breast, axillary, neck/shoulder or arm), 73% reported pain at least in one site. Thirty eight percent of participants felt arm weakness. Participants having each arm/shoulder symptom demonstrated significant higher DASH score then those who hasn't symptom. Among the 12 arm/shoulder symptoms, the associated factors of DASH were arm weakness, neck/shoulder pain, shoulder range of motion limitation and chest/breast pain (adjust R2=45.2%). Arm weakness, neck/shoulder and chest/breast pain were associated with physical functioning of QOL (adjust R2=35.0%). Arm weakness was also a predictor of other 3 functional domains (role, emotional and cognition) and global QOL. However, arm and axillary swelling was not a predictor of DASH and QOL.
Conclusion(s): Treatment-related upper limb impairments were common in women after breast cancer surgery and had negative impact on upper extremity function and QOL. Self-reported arm weakness, motion restriction and pain were associated with poor upper limb function and QOL.
Implications: In order to promote upper extremity function and quality of life in women with breast cancer after surgery, further physical therapy may be needed if they complain arm weakness, pain and shoulder motion restriction.
Keywords: breast cancer, upper body impairment, upper extremity function
Funding acknowledgements: This research was supported by Ntional Taiwan University Hospital.
Purpose: This study aimed (1) to investigate the prevalence of arm/shoulder symptoms after breast cancer surgery; (2) to determine the impact of arm/shoulder symptoms on upper extremity function and QOL; (3) to identify symptoms associated with upper extremity function and quality of life.
Methods: Cross-sectional survey and medical chart review were conducted to collect data including demographic, breast cancer related treatments, self-reported of 12 arm/shoulder complaints (pain, motion restriction, swelling and weakness). Participants were also fulfilled the questionnaires Disabilities of the arm, shoulder, and hand (DASH) which represented limitation of activity and participation in upper extremity, and the European Organization for Research and Treatment of Cancer (EORTC QLQ C-30) questionnaire for QOL.
Results: A total of 249 women post-breast cancer surgery (ranged from 2 weeks to 27 years) participated in this study. Among them, 82% participants reported at least one arm/shoulder symptom, and with mean 4.5±3.6 symptoms. Pain was the most common symptom (38%~46% in chest/breast, axillary, neck/shoulder or arm), 73% reported pain at least in one site. Thirty eight percent of participants felt arm weakness. Participants having each arm/shoulder symptom demonstrated significant higher DASH score then those who hasn't symptom. Among the 12 arm/shoulder symptoms, the associated factors of DASH were arm weakness, neck/shoulder pain, shoulder range of motion limitation and chest/breast pain (adjust R2=45.2%). Arm weakness, neck/shoulder and chest/breast pain were associated with physical functioning of QOL (adjust R2=35.0%). Arm weakness was also a predictor of other 3 functional domains (role, emotional and cognition) and global QOL. However, arm and axillary swelling was not a predictor of DASH and QOL.
Conclusion(s): Treatment-related upper limb impairments were common in women after breast cancer surgery and had negative impact on upper extremity function and QOL. Self-reported arm weakness, motion restriction and pain were associated with poor upper limb function and QOL.
Implications: In order to promote upper extremity function and quality of life in women with breast cancer after surgery, further physical therapy may be needed if they complain arm weakness, pain and shoulder motion restriction.
Keywords: breast cancer, upper body impairment, upper extremity function
Funding acknowledgements: This research was supported by Ntional Taiwan University Hospital.
Topic: Oncology, HIV & palliative care; Musculoskeletal: upper limb
Ethics approval required: Yes
Institution: National Taiwan University Hospital
Ethics committee: Research Ethics Committee
Ethics number: 201208073RIC
All authors, affiliations and abstracts have been published as submitted.
