title: Arm symptoms and overall survival in Brazilian patients with advanced breast cancer.
abstract: BACKGROUND
  Advanced breast cancer is a very frequent serious public health problem.
  
  
  OBJECTIVE
  This study aimed to analyze the prevalence of arm symptoms and overall survival in affected patients.
  
  
  METHODS
  A retrospective cohort study was accomplished in 196 women presenting with advanced breast cancer. A descriptive analysis was carried out by and overall survival probabilities were calculated according to Kaplan-Meier method and Cox regression.
  
  
  RESULTS
  These included 196 woman had a medium age of 55.9 years, the majority being obese (71.3%) and having a IIIB clinical staging (52.3%). The most prevalent arm symptoms were pain (54.6%), paresthesia in upper limb (8.5%), lymphedema (> 200 ml) (6.6%), shoulder restriction (4.7%) and axillary web syndrome (0.6%). The median follow-up was 18.7 months (SD 7,33), 4.0% of the patients had metastasis and 31.6% were dead. The mean free disease survival was 20.4 months (95% CI 18.4-22.4), and the mean survival time was 26.3 months (95% CI 24.7-28.0). After adjusted the association with arm symptom and overall survival for clinical stage and presence of distant metastasis, the shoulder restriction was a predict variable, were represents the risk 2.59 for worse survival in compared with woman with no shoulder restriction (CI 95% 1.06-5.98).
  
  
  CONCLUSIONS
  The population studied at this study presented high prevalence of complications earlier than neo adjuvant treatment. After controlling for effects of tumor variables, the shoulder restriction was statistically associated with poor overall survival after 2 years.
authors.affiliation: Centro Universitário Augusto Motta and Instituto Nacional de Cancer, Brazil. bergmann@inca.gov.br
authors.forename: Anke
authors.initials: A
authors.lastname: Bergmann
authors.forename: Nathalia Santos
authors.initials: NS
authors.lastname: Bourrus
authors.forename: Cristiane Monteiro
authors.initials: CM
authors.lastname: de Carvalho
authors.forename: Ricardo de Almeida
authors.initials: Rde A
authors.lastname: Dias
authors.forename: Erica Alves Nogueira
authors.initials: EA
authors.lastname: Fabro
authors.forename: Núria Silva
authors.initials: NS
authors.lastname: Sales
authors.forename: Suzana Sales
authors.initials: SS
authors.lastname: de Aguiar
mesh_terms: D000328:Adult; D000368:Aged; D001132:Arm / Q000503:physiopathology*; D001938:Brazil; D001943:Breast Neoplasms / Q000175:diagnosis* / Q000401:mortality*; D015331:Cohort Studies; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008209:Lymphedema; D008875:Middle Aged; D009765:Obesity; D010146:Pain; D010292:Paresthesia; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D012782:Shoulder