title: Upper-body morbidity following breast cancer treatment is common, may persist longer-term and adversely influences quality of life.
abstract: BACKGROUND
  Impairments in upper-body function (UBF) are common following breast cancer. However, the relationship between arm morbidity and quality of life (QoL) remains unclear. This investigation uses longitudinal data to describe UBF in a population-based sample of women with breast cancer and examines its relationship with QoL.
  
  
  METHODS
  Australian women (n=287) with unilateral breast cancer were assessed at three-monthly intervals, from six- to 18-months post-surgery (PS). Strength, endurance and flexibility were used to assess objective UBF, while the Disability of the Arm, Shoulder and Hand questionnaire and the Functional Assessment of Cancer Therapy-Breast questionnaire were used to assess self-reported UBF and QoL, respectively.
  
  
  RESULTS
  Although mean UBF improved over time, up to 41% of women revealed declines in UBF between six- and 18-months PS. Older age, lower socioeconomic position, treatment on the dominant side, mastectomy, more extensive lymph node removal and having lymphoedema each increased odds of declines in UBF by at least two-fold (p<0.05). Lower baseline and declines in perceived UBF between six- and 18-months PS were each associated with poorer QoL at 18-months PS (p<0.05).
  
  
  CONCLUSIONS
  Significant upper-body morbidity is experienced by many following breast cancer treatment, persisting longer term, and adversely influencing the QoL of breast cancer survivors.
authors.affiliation: School of Public Health, Queensland University of Technology, Victoria Park Road, Kelvin Grove, Queensland, 4059, Australia. sc.hayes@qut.edu.au
authors.forename: Sandra C
authors.initials: SC
authors.lastname: Hayes
authors.forename: Sheree
authors.initials: S
authors.lastname: Rye
authors.forename: Diana
authors.initials: D
authors.lastname: Battistutta
authors.forename: Tracey
authors.initials: T
authors.lastname: DiSipio
authors.forename: Beth
authors.initials: B
authors.lastname: Newman
mesh_terms: D001315:Australia; D001943:Breast Neoplasms / Q000473:pathology / Q000601:surgery*; D005260:Female; D006801:Humans; D008209:Lymphedema / Q000209:etiology / Q000523:psychology; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology* / Q000209:etiology; D011594:Psychometrics; D011788:Quality of Life; D016059:Range of Motion, Articular; D020127:Recovery of Function; D015203:Reproducibility of Results; D012647:Self-Assessment; D012720:Severity of Illness Index; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires; D034941:Upper Extremity
references.citation: Breast Cancer Res Treat. 2002 May;73(1):31-6
references.pmid: 12083629
references.citation: Aust N Z J Public Health. 2009 Dec;33(6):534-9
references.pmid: 20078570
references.citation: Breast Cancer Res Treat. 2000 Dec;64(3):275-86
references.pmid: 11200778
references.citation: Breast Cancer Res Treat. 2005 Nov;94(1):1-10
references.pmid: 16172793
references.citation: Oncology. 1993 Nov-Dec;50(6):445-9
references.pmid: 8233285
references.citation: Acta Oncol. 2003;42(7):710-8
references.pmid: 14690156
references.citation: Cancer. 2000 Feb 1;88(3):608-14
references.pmid: 10649254
references.citation: Am J Surg. 2003 Feb;185(2):127-30
references.pmid: 12559441
references.citation: J Rehabil Med. 2005 May;37(3):180-8
references.pmid: 16040476
references.citation: J Clin Oncol. 2002 Oct 15;20(20):4242-8
references.pmid: 12377968
references.citation: J Surg Oncol. 2002 Mar;79(3):151-5; discussion 156
references.pmid: 11870664
references.citation: Eur J Cancer. 2001 May;37(8):991-9
references.pmid: 11334724
references.citation: Br J Cancer. 2003 Aug 18;89(4):648-52
references.pmid: 12915872
references.citation: J Clin Oncol. 2008 Mar 10;26(8):1355-63
references.pmid: 18227528
references.citation: J Clin Oncol. 2008 Jul 20;26(21):3536-42
references.pmid: 18640935
references.citation: J Clin Epidemiol. 1996 May;49(5):535-44
references.pmid: 8636727
references.citation: J Clin Oncol. 1997 Mar;15(3):974-86
references.pmid: 9060536
references.citation: J Sci Med Sport. 2009 Jul;12(4):428-34
references.pmid: 19428291
references.citation: Eur J Surg Oncol. 2003 Apr;29(3):229-38
references.pmid: 12657232
references.citation: J Surg Oncol. 1992 May;50(1):47-52
references.pmid: 1573894
references.citation: Disabil Rehabil. 2004 Jan 21;26(2):78-84
references.pmid: 14668143
references.citation: J Surg Oncol. 2003 Aug;83(4):204-11
references.pmid: 12884231
references.citation: Ann Surg Oncol. 2004 Nov;11(11):1018-24
references.pmid: 15525832
references.citation: Psychooncology. 2011 Oct;20(10):1084-91
references.pmid: 20672245
references.citation: Eur J Cancer. 1997 Feb;33(2):193-9
references.pmid: 9135487