title: Prevalence of breast cancer treatment sequelae over 6 years of follow-up: the Pulling Through Study.
abstract: BACKGROUND
  There is a need to better describe and understand the prevalence of breast cancer treatment-related adverse effects amenable to physical therapy and rehabilitative exercise. Prior studies have been limited to single issues and lacked long-term follow-up. The Pulling Through Study provides data on prevalence of adverse effects in breast cancer survivors followed over 6 years.
  
  
  METHODS
  A population-based sample of Australian women (n = 287) diagnosed with invasive, unilateral breast cancer was followed for a median of 6.6 years and prospectively assessed for treatment-related complications at 6, 12, and 18 months and 6 years after diagnosis. Assessments included postsurgical complications, skin or tissue reaction to radiation therapy, upper-body symptoms, lymphedema, 10% weight gain, fatigue, and upper-quadrant function. The proportion of women with positive indication for each complication and 1 or more complication was estimated using all available data at each time point. Women were only considered to have a specific complication if they reported the highest 2 levels of the Likert scale for self-reported issues.
  
  
  RESULTS
  At 6 years after diagnosis, more than 60% of women experienced 1 or more side effects amenable to rehabilitative intervention. The proportion of women experiencing 3 or more side effects decreased throughout follow-up, whereas the proportion experiencing no side effects remained stable around 40% from 12 months to 6 years. Weight gain was the only complication to increase in prevalence over time.
  
  
  CONCLUSIONS
  These data support the development of a multidisciplinary prospective surveillance approach for the purposes of managing and treating adverse effects in breast cancer survivors.
authors.affiliation: Division of Clinical Epidemiology and Biostatistics, University of Pennsylvania Perelman School of Medicine, Abramson Cancer Center, Philadelphia, Pennsylvania 19104-6021, USA. schmitz@mail.med.upenn.edu
authors.forename: Kathryn H
authors.initials: KH
authors.lastname: Schmitz
authors.forename: Rebecca M
authors.initials: RM
authors.lastname: Speck
authors.forename: Sheree A
authors.initials: SA
authors.lastname: Rye
authors.forename: Tracey
authors.initials: T
authors.lastname: DiSipio
authors.forename: Sandra C
authors.initials: SC
authors.lastname: Hayes
mesh_terms: D000328:Adult; D017677:Age Distribution; D000368:Aged; D001315:Australia / Q000453:epidemiology; D001943:Breast Neoplasms / Q000453:epidemiology* / Q000628:therapy*; D015984:Causality; D003131:Combined Modality Therapy / Q000009:adverse effects* / Q000379:methods; D015897:Comorbidity; D005221:Fatigue / Q000453:epidemiology* / Q000209:etiology / Q000534:rehabilitation; D005260:Female; D006801:Humans; D008134:Long-Term Care; D008137:Longitudinal Studies; D008209:Lymphedema / Q000453:epidemiology* / Q000209:etiology / Q000534:rehabilitation; D008875:Middle Aged; D010146:Pain / Q000453:epidemiology* / Q000209:etiology / Q000534:rehabilitation; D015995:Prevalence; D011788:Quality of Life; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires; D017741:Survivors; D015430:Weight Gain