Symptoms of Arm Lymphedema and its Effects on Health-Related Quality of Life Among Disease-Free Female Breast Cancer Survivors

Abstract

s / Annals of Epidemiology 23 (2013) 581e598 585 P15-S. Symptoms of Arm Lymphedema and its Effects on Health-Related Quality of Life Among Disease-Free Female Breast Cancer Survivors K. Togawa, J. Sullivan-Halley, H. Ma, L. Bernstein. University of Southern California, City of Hope Comprehensive Cancer Center Purpose: Arm lymphedema (LE) remains one of the most common and debilitating conditions after breast cancer treatment. Although LE has been shown to lower health-related quality of life (HRQOL), the symptomspecific effects on HRQOL are unclear. This study evaluated the association of LE symptoms with the HRQOL of breast cancer survivors. Methods: Data were collected from 600 disease-free female breast cancer survivors, ages 35-64 years at diagnosis, who participated in the Health, Eating, Activity, and Lifestyle Study. Non-Hispanic white, Hispanic white and black women who participated in this prospective cohort study reported presence or absence of nine LE symptoms and completed the Short-Form 36Item Health Survey (SF-36), on average, three years after diagnosis. Based on SF-36, we generated two HRQOL measures, physical (PCS) and mental (MCS) component summary scores. Linear regression models were fit to evaluate the association of LE symptoms with HRQOL. Results: Among 136 women who experienced LE, the most common symptoms were tightness (69%), heaviness (62%), and numbness (59%). None of these symptoms were associated with PCS or MCS after adjusting for sociodemographic factors and clinical characteristics (p>0.05 for all) whereas feeling tension in the arm decreased PCS (b1⁄4-6.7, p1⁄40.001) and having burning pain in the arm decreased MCS (b1⁄4-6.1, p1⁄40.02). Conclusion: Management of symptoms of tension and burning pain in the LE-affected arm may improve HRQOL after breast cancer treatment. P16. Impact of Pain Among Hispanic and Non-Hispanic White Long-Term Breast Cancer Survivors Dongyan Yang, Richard N. Baumgartner, Kathy B. Baumgartner. Department of Epidemiology & Population Health, University of Louisville Purpose: Few studies have investigated chronic body pain among longterm breast cancer survivors. The primary objective of this analysis was to examine three measurements of pain and related factors for long-term, Hispanic (H) and non-Hispanic white (NHW), breast cancer survivors. Methods: A total of 187 breast cancer cases (New Mexico Women's Health Study) were interviewed 12-15 years postdiagnosis. Data on 3 pain scales were collected: McDonald post-mastectomy; McGill over past year; SF-36 pain subscale over past 4 weeks. Multivariate linear regression was conducted to investigate the association of SF-36 pain score with body mass index (BMI), fatigue and comorbidity, adjusting for ethnicity, age, education, physical activity, smoking, depression, stage and treatment. Results: TheMcGill andSF-36werehighlycorrelated (p<0.01). Fortytwo cases reported post-mastectomy pain (17% in situ; 49% localized; 34% regional). A significantly higher number of NHW(92%)women reported post-mastectomy pain 5 years compared to H (56%) women, whereas H women reported amean thatwas 6 units higher on theMcGill Pain Scale than reported byNHW women (p1⁄40.007). Among NHW women, fatigue was inversely associated with pain reported on the SF-36 (p1⁄40.005) and comorbidity measured by the Charlson Index was associated with more severe pain (p1⁄40.03), whereas BMI was associated with increased pain in H women (p1⁄40.03). Conclusion: A large percentage of women continue to report the presence of persistent pain more than a decade after diagnosis, and fatigue, comorbidity and BMI are influential factors.