Abstract
BackgroundImpairments in upper-body function (UBF) are common following breast cancer. However, the relationship between arm morbidity and quality of life (QoL) remains unclear. This investigation uses longitudinal data to describe UBF in a population-based sample of women with breast cancer and examines its relationship with QoL.MethodsAustralian women (n = 287) with unilateral breast cancer were assessed at three-monthly intervals, from six- to 18-months post-surgery (PS). Strength, endurance and flexibility were used to assess objective UBF, while the Disability of the Arm, Shoulder and Hand questionnaire and the Functional Assessment of Cancer Therapy-Breast questionnaire were used to assess self-reported UBF and QoL, respectively.ResultsAlthough mean UBF improved over time, up to 41% of women revealed declines in UBF between six- and 18-months PS. Older age, lower socioeconomic position, treatment on the dominant side, mastectomy, more extensive lymph node removal and having lymphoedema each increased odds of declines in UBF by at least two-fold (p < 0.05). Lower baseline and declines in perceived UBF between six- and 18-months PS were each associated with poorer QoL at 18-months PS (p < 0.05).ConclusionsSignificant upper-body morbidity is experienced by many following breast cancer treatment, persisting longer term, and adversely influencing the QoL of breast cancer survivors.
Highlights
Impairments in upper-body function (UBF) are common following breast cancer
These design limitations are critical: lack of longitudinal data compromises generalisability of study results; focus on treatment outcomes has overshadowed the potential impact of other personal and/or behavioural characteristics; and previous work has demonstrated that correlations between objective and self-reported measures of UBF are only modest (r = -0.2-0.3) indicating they reflect different constructs, with both the direction and magnitude of relationships with other characteristics varying depending on how UBF is measured [15]
Those treated on the dominant side show better UBF when assessed clinically, but report poorer perceived function, when compared with those treated on their non-dominant side
Summary
Impairments in upper-body function (UBF) are common following breast cancer. the relationship between arm morbidity and quality of life (QoL) remains unclear. The literature relies on self-reported measures of UBF, typically in the absence of clinical assessment These design limitations are critical: lack of longitudinal data compromises generalisability of study results; focus on treatment outcomes has overshadowed the potential impact of other personal and/or behavioural characteristics; and previous work has demonstrated that correlations between objective and self-reported measures of UBF are only modest (r = -0.2-0.3) indicating they reflect different constructs, with both the direction and magnitude of relationships with other characteristics varying depending on how UBF is measured [15]. Those treated on the dominant side show better UBF when assessed clinically, but report poorer perceived function, when compared with those treated on their non-dominant side
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