title: Arm/hand swelling and perceived functioning among breast cancer survivors 12 years post-diagnosis: CALGB 79804.
abstract: BACKGROUND
  Lymphedema is an under-reported and debilitating consequence of axillary node dissection among breast cancer survivors. This study describes the characteristics of arm and hand swelling in relation to perceived physical and mental health functioning among breast cancer survivors 9-16 years post-diagnosis who previously participated in a clinical trial coordinated by the Cancer and Leukemia Group B (CALGB 8541).
  
  
  METHODS
  Eligible survivors of CALGB 8541 completed questionnaires assessing demographics, arm/hand swelling, perceived physical functioning, and mental health.
  
  
  RESULTS
  Two hundred forty-five women (94% white, mean age = 63, on average 12.4 years post-diagnosis) completed questionnaires (participation rate = 78%). Seventy-five women (31%) reported arm/hand swelling since their surgery. Of these women, 76% reported current swelling and half reported constant swelling, mainly in the upper arm. Swelling was reported as mild or moderate in 88% of the women. Women who reported severe swelling had significantly worse physical functioning and trended toward worse depressive symptoms and poorer mental health (lower mental SF-36 scores) as well. Activity-limiting swelling was also significantly associated with worse physical functioning. Although swelling interfered with wearing clothing (36%) and perceptions about general appearance (32%), only 37% of women sought treatment for swelling.
  
  
  CONCLUSIONS
  Arm/hand swelling is a chronic problem for a subgroup of long-term survivors of breast cancer, negatively affecting physical functioning.
  
  
  CONCLUSIONS
  Educational efforts are needed as part of a comprehensive survivorship care plan to raise awareness about lymphedema so that survivors may identify this complication, seek treatment early, and potentially improve their physical functioning.
authors.affiliation: Comprehensive Cancer Center, The Ohio State University, A356 Starling-Loving Hall, 320 W. 10th Avenue, Columbus, OH, USA.
authors.forename: Jill M
authors.initials: JM
authors.lastname: Oliveri
authors.forename: Jeannette M
authors.initials: JM
authors.lastname: Day
authors.forename: Catherine M
authors.initials: CM
authors.lastname: Alfano
authors.forename: James E
authors.initials: JE
authors.lastname: Herndon
authors.forename: Mira L
authors.initials: ML
authors.lastname: Katz
authors.forename: Marisa A
authors.initials: MA
authors.lastname: Bittoni
authors.forename: Kathleen
authors.initials: K
authors.lastname: Donohue
authors.forename: Electra D
authors.initials: ED
authors.lastname: Paskett
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001132:Arm / Q000503:physiopathology*; D001943:Breast Neoplasms / Q000175:diagnosis / Q000453:epidemiology / Q000503:physiopathology / Q000534:rehabilitation*; D005260:Female; D006225:Hand / Q000503:physiopathology*; D006801:Humans; D008209:Lymphedema / Q000453:epidemiology* / Q000503:physiopathology*; D008603:Mental Health / Q000706:statistics & numerical data; D008875:Middle Aged; D009043:Motor Activity / Q000502:physiology*; D010465:Perception / Q000502:physiology; D011379:Prognosis; D020127:Recovery of Function / Q000502:physiology; D017741:Survivors
references.citation: N Engl J Med. 1994 May 5;330(18):1253-9
references.pmid: 8080512
references.citation: Am J Surg. 2004 Jan;187(1):69-72
references.pmid: 14706589
references.citation: CA Cancer J Clin. 2000 Sep-Oct;50(5):292-307; quiz 308-11
references.pmid: 11075239
references.citation: Can Fam Physician. 2005 Feb;51:246-7
references.pmid: 16926934
references.citation: Radiother Oncol. 1992 Nov;25(3):160-6
references.pmid: 1470692
references.citation: Cancer Epidemiol Biomarkers Prev. 2007 Apr;16(4):775-82
references.pmid: 17416770
references.citation: Am J Surg. 1999 Mar;177(3):184-7; discussion 188
references.pmid: 10219851
references.citation: Cancer. 1998 Dec 15;83(12 Suppl American):2776-81
references.pmid: 9874397
references.citation: J Clin Oncol. 2002 Oct 15;20(20):4242-8
references.pmid: 12377968
references.citation: Breast Cancer Res Treat. 1992;21(2):139-45
references.pmid: 1627817
references.citation: Cancer. 1998 Dec 15;83(12 Suppl American):2874-6
references.pmid: 9874414
references.citation: J Nerv Ment Dis. 1977 Feb;164(2):77-87
references.pmid: 836487
references.citation: Med Care. 1994 Jan;32(1):40-66
references.pmid: 8277801
references.citation: Br J Surg. 1986 Jul;73(7):580-4
references.pmid: 3730795
references.citation: Breast Cancer Res Treat. 2005 May;91(2):153-61
references.pmid: 15868443
references.citation: Med Care. 1993 Mar;31(3):247-63
references.pmid: 8450681
references.citation: Oncol Nurs Forum. 1997 Jun;24(5):875-82
references.pmid: 9201739
references.citation: Cancer. 1981 Mar 1;47(5):877-81
references.pmid: 7013962
references.citation: Support Care Cancer. 2005 Nov;13(11):904-11
references.pmid: 15812652
references.citation: Psychooncology. 2008 Nov;17(11):1108-20
references.pmid: 18314912
references.citation: Am J Epidemiol. 1993 Apr 15;137(8):845-57
references.pmid: 8484376
references.citation: Int Wound J. 2005 Mar;2(1):47-62
references.pmid: 16722853
references.citation: Lymphology. 2006 Dec;39(4):185-92
references.pmid: 17319631
references.citation: Cancer. 2005 Aug 1;104(3):457-66
references.pmid: 15968692
references.citation: Patient Educ Couns. 2007 Jun;66(3):311-8
references.pmid: 17331692
references.citation: Breast J. 2000 Nov;6(6):373-378
references.pmid: 11348395
references.citation: J Pain Symptom Manage. 1993 May;8(4):226-33
references.pmid: 7963764
references.citation: Arch Surg. 2002 Nov;137(11):1253-7
references.pmid: 12413312
references.citation: Can J Surg. 1993 Aug;36(4):315-20
references.pmid: 8370012
references.citation: JAMA. 1993 Aug 18;270(7):835-40
references.pmid: 8340982
references.citation: Cancer. 2003 Aug 15;98(4):679-89
references.pmid: 12910510
references.citation: Breast Cancer Res Treat. 2003 May;79(1):47-57
references.pmid: 12779081
references.citation: Am J Prev Med. 1994 Mar-Apr;10(2):77-84
references.pmid: 8037935
references.citation: Cancer. 2001 Sep 15;92(6):1368-77
references.pmid: 11745212
references.citation: Cancer. 1993 Dec 1;72(11):3248-52
references.pmid: 8242549
references.citation: Lymphology. 1997 Mar;30(1):35-6
references.pmid: 9106138
references.citation: Oncol Nurs Forum. 2004 Jan-Feb;31(1):97-104
references.pmid: 14722593
references.citation: Radiology. 1991 Jul;180(1):177-84
references.pmid: 2052688