The role of occupational upper extremity use in breast cancer related upper extremity lymphedema.
BACKGROUND
Upper extremity (UE) use has been related to breast cancer-related lymph edema (BCRL). Our aim was to evaluate severity of BCRL in different occupation groups, according to upper extremity use.


METHODS
Fifty-five women with BCRL were recruited. Group-1 (n = 21), with a mean age of 59, included patients who worked continuously <30 min at a time and <or=8 h per day. Group-2 (n = 15), with a mean age of 54, were patients who worked continuously between 30 to 60 min at a time, and <or=8 h per day. Group-3 (n = 19), who had a mean age of 51, included patients who were working continuously for >1 h and >8 h per day.


RESULTS
The age, operation type, infection occurrence, radiotherapy status, and the operation on the side of the dominant hand were not statistically different between the groups. The stage and grade of the BCRL in group-3 were higher than the other groups (both p < 0.001). The restriction of shoulder movements on the operation side (p = 0.04) and shoulder physiotherapy need (p < 0.001) were the highest in group-3. Arm pain (p = 0.004) and pain medicine needs (p = 0.028) in group-1 were lower than the other groups.


CONCLUSIONS
Group-3 had the worst BCRL clinical stage and grade status and other breast cancer treatment related morbities. Occupations that require greater use of the upper extremities. At present there is a need for closer monitoring of patients with more severe BCRL. Potential exacerbating and maintaining factors of functional limitations and pain need to considered so that clinical management addresses these in relation to daily use of the affected UE.
Tahan
Gulgun
G
Department of Surgery, Surgical Oncology, Magee-Womens Hospital of University of Pittsburgh, Pittsburgh, PA, 15213, USA.
Johnson
Ronald
R
Mager
Lisa
L
Soran
Atilla
A
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001943:Breast Neoplasms / Q000503:physiopathology*; D005260:Female; D018737:Hand Strength; D006801:Humans; D008209:Lymphedema / Q000503:physiopathology* / Q000628:therapy; D008875:Middle Aged; D009784:Occupational Diseases / Q000150:complications / Q000453:epidemiology*; D017063:Outcome Assessment, Health Care; D010146:Pain / Q000209:etiology / Q000473:pathology; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors; D034941:Upper Extremity / Q000503:physiopathology*