title: Do breast cancer survivors' post-surgery difficulties with recreational activities persist over time?
abstract: BACKGROUND
  Most longitudinal breast cancer studies have found that treatment-related sequelae such as arm morbidity [lymphedema, pain, and range of motion (ROM) restrictions] can have a significant impact on quality of life. In a previous study, we found that at 6-12 months after breast cancer surgery, 49% of participants had difficulties engaging in recreational activities and that arm morbidity significantly predicted difficulties with participation in recreation.
  
  
  METHODS
  A longitudinal national study employing clinical assessments and survey methods followed 178 women over 43 months (3.6 years) to assess issues related to arm morbidity post-breast cancer surgery. Hierarchical multiple regression analyses were conducted to identify which variables were predictive of recreational difficulties experienced by women 8 and 43 months post-surgery.
  
  
  RESULTS
  Between 8 months (T1) and 43 months (T2) post-breast cancer surgery, women demonstrated slight increases in lymphedema. Conversely, a significant decrease was observed in the number of ROM restrictions and pain when using the arm. Despite the overall improvements in arm morbidity, some women continued to report moderate pain and ROM restrictions. The two arm morbidity factors were found to be statistically significant (p < 0.001) predictors of recreational difficulties at both 8 and 43 months post-surgery, with pain accounting for the greatest proportion of variance.
  
  
  CONCLUSIONS
  Pain and ROM restrictions were the only significant predictors of recreational difficulties during the first 3.6 years after breast cancer surgery. Specifically, women who still experience pain years after breast cancer surgery report difficulties in their recreational pursuits.
  
  
  CONCLUSIONS
  Pain and ROM restrictions may prohibit participation in recreational activity and targeted intervention should be sought.
authors: Dalhousie University Family Medicine Teaching Unit, Dr. Everett Chalmers Regional Hospital, 700 Priestman Street, Fredericton, NB, Canada. baukje.miedema@horizonNB.ca
authors: Baukje
authors: B
authors: Miedema
authors: Ryan
authors: R
authors: Hamilton
authors: Sue
authors: S
authors: Tatemichi
authors: Roanne
authors: R
authors: Thomas-Maclean
authors: Thomas F
authors: TF
authors: Hack
authors: Elizabeth
authors: E
authors: Quinlan
authors: Anna
authors: A
authors: Towers
authors: Andrea
authors: A
authors: Tilley
authors: Winkle
authors: W
authors: Kwan
mesh_terms: D001943:Breast Neoplasms / Q000401:mortality / Q000534:rehabilitation* / Q000601:surgery*; D005260:Female; D006801:Humans; D007899:Leisure Activities; D008137:Longitudinal Studies; D008408:Mastectomy; D008875:Middle Aged; D011183:Postoperative Complications; D011379:Prognosis; D015996:Survival Rate; D017741:Survivors / Q000523:psychology*; D013997:Time Factors