Impairments, disabilities and health related quality of life after treatment for breast cancer: a follow-up study 2.7 years after surgery.
OBJECTIVE
The aim of this study was to assess impairments, disabilities and health related Quality of Life (QOL) after treatment of breast cancer and to analyse the relationship between treatment modalities, impairments, disabilities and health related QOL.


METHODS
Fifty-five patients who underwent a modified radical mastectomy or a segmental mastectomy with axillary lymph node dissection were retrospectively assessed with a mean follow up of 2.7 years after treatment. Impairments were assessed by means of measuring active shoulder range of motion, grip strength, arm volume and pain. Disabilities were assessed by means of the Shoulder Disability Questionnaire (SDQ) and health related QOL was assessed by means of the RAND 36-item Health Survey (RAND-36).


METHODS
University Hospital Groningen (The Netherlands).


RESULTS
Pain (60%) and reduction of grip-strength (40%) were the most frequent impairments found. The prevalence of impaired range of motion and oedema was 9 - 16% respectively 15%. Mean group score of the SDQ was 33.7 (sd: 32.1) and mean scores of the RAND-36 differed significantly for physical functioning, vitality and health perception to that of a female norm group. Radiotherapy and chemotherapy were significant factors in the prediction of impaired range of motion. Pain and restricted range of motion explained 61% respectively 12% of the variance in disability (SDQ). In the prediction of health related QOL, pain, grip strength and arm volume were significant factors respectively in six, three and two domains.


CONCLUSIONS
Pain is the most frequent assessed impairment after breast cancer treatment with strong relationship to perceived disability and health related QOL. Disability is mild and health related QOL (RAND-36) differed in three of the nine domains with a female norm group.
Rietman
Johan S
JS
Department of Rehabilitation Medicine, University Hospital Groningen, The Netherlands. j.s.rietman@planet.nl
Dijkstra
Pieter U
PU
Debreczeni
Rolanda
R
Geertzen
Jan H B
JH
Robinson
Douglas P H
DP
De Vries
Jaap
J
D000203:Activities of Daily Living; D001943:Breast Neoplasms / Q000534:rehabilitation* / Q000628:therapy; D003131:Combined Modality Therapy; D004185:Disability Evaluation; D005260:Female; D005500:Follow-Up Studies; D006304:Health Status; D006801:Humans; D008408:Mastectomy / Q000534:rehabilitation; D008875:Middle Aged; D009426:Netherlands / Q000453:epidemiology; D011183:Postoperative Complications / Q000453:epidemiology / Q000534:rehabilitation; D011788:Quality of Life; D012189:Retrospective Studies