Swelling, Numbness, Pain, and Their Relationship to Arm Function Among Breast Cancer Survivors: A Disablement Process Model Perspective

Abstract

The disablement process model proposed by Nagi in 1965 and subsequently expanded by Verbrugge and Jette was used heuristically to study the relationships among morbidities and arm/shoulder function limitations that breast cancer survivors experience in the period following treatment. A telephone survey was administered to 148 patients (67%) from among 222 breast cancer survivors who had undergone surgery in 1997 and 1998. Sixty-three percent of respondents reported experiencing some numbness, while 35% noticed swelling. Between 13% and 15% reported moderate to severe pain. Similar proportions said the occurrence of pain ranged from intermittent to constant. Between 1% and 4% reported problems with shoulder abduction and flexion and a decrease in arm strength and daily use of the arm. Swellings in the torso and arm tended to cluster into two different factors. Numbness followed a similar pattern. Apart from numbness in the arm, all the other factors had strong significant associations with one another. In multiple regression analyses, current pain intensity and swelling in the arm were independently related to current functional status of the arm/shoulder. The results suggest that it may be feasible to use patients' self-reports to develop a simple lymphedema-specific tool to monitor the functional status of women living with or at risk for lymphedema. Such a tool, if properly designed and implemented, would allow for the timely introduction of lymphedema or pain management strategies to improve arm function and ultimately the quality of life of breast cancer survivors.

A population‐based study of the impact of specific symptoms on quality of life in women with breast cancer 1 year after diagnosis

“…34 Similarly, more than onethird of all patients with conventional axillary dissection after breast cancer surgery suffer persistent arm problems, which may substantially affect QOL. 2,3,35,36 In light of the strong interrelation between various symptoms, including fatigue, sleeping disorders, and pain, it is hard to judge whether interventions specifically aimed to reduce fatigue will also substantially improve QOL throughout a broad range of various domains or whether a combined approach is more effective. 25 However, it has been shown that patients whose fatigue improved reported substantially greater improvements in energy, ability to perform usual activities, and overall health.…”

Body Image of Women with Breast Cancer After Mastectomy: A Qualitative Research

“…Some of the participants in our study declared that after mastectomy they could not do housework or work in the garden, and this situation made them feel empty and inadequate. Other studies have reported that women felt unable to carry out daily life activities such as shopping, cleaning the home, and hanging clothes (32)(33)(34). Women who cannot fulfill their role in life after undergoing a mastectomy may experience feelings of loss related to the things they used to do so easily.…”

Effects of Clinical Pilates Exercises on Patients Developing Lymphedema after Breast Cancer Treatment: A Randomized Clinical Trial

“…These publications report that in particular, shoulder flexion, abduction, and external rotation angles decreased, that patients' activities of daily living were restricted, and that their quality of life was adversely affected (14)(15)(16)(17).…”