The relation between arm/shoulder problems and quality of life in breast cancer survivors: a cross-sectional and longitudinal study

Abstract

BackgroundThis cross-sectional and longitudinal study of breast cancer survivors (BCSs) examines the associations between arm/shoulder problems (ASPs), which consist of pain, restricted mobility and lymphedema, and different aspects of quality of life (QoL).MethodsBCSs who had breast surgery, axillary lymph node dissection and radiotherapy (n = 255) were examined in 2004 (mean 4.1 years post-surgery) and a sub-sample (n = 187) was re-examined in 2007. ASPs was rated clinically in 2004 and by self-report (EORTC BR23) in 2004 and 2007. QoL was self-reported with The Short Form-36 (SF-36) and The Impact of Cancer scale (IOC).ResultsIn 2004 BCSs with ASPs showed significantly poorer mean scores in most SF-36 domains compared to those without. No group differences were observed for positive IOC domains, while BCSs with ASPs showed significantly poorer mean scores in the negative ones. BCSs with clinically defined movement restriction showed significantly poorer SF-36 and negative IOC mean scores than those with clinically defined lymphedema. The longitudinal sub-study of self-rated pain, restricted mobility and lymphedema showed significant changes over time only for negative IOC domains in the pain group. Self-rated restricted mobility and lymphedema were significantly associated with most SF-36 domains both in 2004 and 2007, while few were associated with pain. Self-rated pain and restricted mobility showed significant associations with negative IOC domains.Implications for cancer survivorsNot only lymphedema, but pain and restricted mobility in the arm/shoulder are significantly associated with poor QoL in BCSs at long-term. These problems should be diagnosed and treated in order to improve QoL.

Symptom Management in Metastatic Breast Cancer

“…Lymphedema may also be associated with other arm and shoulder problems (difficulty lifting, reaching, pain) [46]. Having had an axillary lymph node dissection or radiation to the axilla increases the risk, but any breast cancer patient may develop lymphedema.…”

Patient-reported measures of quality of life and functional capacity in adhesive capsulitis

“…9,16,17 However, the progress of research on QoL outcomes contributes to the perception of patients regarding their health and life by providing a validated subjective score of their symptoms, free from medical bias. 1,3,4,6,14 The main objective of this study was to assess QoL and FC in adhesive capsulitis patients using two assessment instruments, WHOQOL-BREF and DASH. Gupta et al studied the impact of adhesive capsulitis in diabetic and elderly patients but used the Oxford Shoulder Score and Short Form-36 (SF-36) to do so.…”

“…The difficulties in including this evaluation in clinical practice reside mainly in the health professionals' lack of information about its uses and applicability. [1][2][3] Since this assessment reflects the perspective of the patient, and not that of scientists and health professionals, it is widely accepted as an indicator of health in medical interventions. 3 Several tools may be used for this purpose, depending on the situation.…”

“…3 Several tools may be used for this purpose, depending on the situation. [1][2][3][4] The World Health Organization Quality of Life (WHOQOL) questionnaire was initially developed as an expanded questionnaire, the WHOQOL-100, 2 and later as the WHOQOL-BREF. 5 The WHOQOL-BREF is an abbreviated version consisting of the 26 questions on the WHOQOL-100 with the best psychometric performance.…”

The Perioperative Educational Program for Improving Upper Arm Dysfunction in Patients with Breast Cancer at 1-Year Follow-Up: A Prospective, Controlled Trial

“…Therefore, the benefits of this program to assess a breast cancer patient's ability for symptom management using the education that they have received from before surgery in their current daily life must be continued even later than 3 months after surgery. Moreover, predictive factors for decreased QOL in patients with upper arm dysfunction after breast cancer surgery have been reported in several previous studies (Rietman et al 2003(Rietman et al , 2004Morgan et al 2005;Sato and Kuroda 2008;Hayes et al 2010;Smoot et al 2010;Nesvold et al 2011). Therefore, QOL must also be evaluated as an indicator of program effects.…”