title: Predictors of Altered Upper Extremity Function During the First Year After Breast Cancer Treatment.
abstract: The purpose of this study was to evaluate trajectories of and predictors for changes in upper extremity (UE) function in women (n = 396) during the first year after breast cancer treatment.
  
  
  
  Prospective, longitudinal assessments of shoulder range of motion (ROM), grip strength, and perceived interference of function were performed before and for 1 year after surgery. Demographic, clinical, and treatment characteristics were evaluated as predictors of postoperative function.
  
  
  
  Women had a mean (SD) age of 54.9 (11.6) years, and 64% were white. Small but statistically significant reductions in shoulder ROM were found on the affected side over 12 months (P < 0.001). Predictors of interindividual differences in ROM at the 1-month assessment were ethnicity, neoadjuvant chemotherapy, type of surgery, axillary lymph node dissection, and preoperative ROM. Predictors of interindividual differences in changes over time in postoperative ROM were living alone, type of surgery, axillary lymph node dissection, and adjuvant chemotherapy. Declines in mean grip strength from before through 1 month after surgery were small and not clinically meaningful. Women with greater preoperative breast pain interference scores had higher postoperative interference scores at all postoperative assessments.
  
  
  
  Some of the modifiable risk factors identified in this study can be targeted for intervention to improve UE function in these women.
authors.affiliation: From the School of Medicine (B. Smoot, JDL, GA, KT), and School of Nursing (SMP, DH, JM, CM), University of California San Francisco, San Francisco, California; School of Dentistry, New York University, New York, New York (BEA, B. Schmidt); Redwood Regional Medical Group, Santa Rosa, California (CE); and School of Medicine, Stanford University, Stanford, California (LD).
authors.forename: Betty
authors.initials: B
authors.lastname: Smoot
authors.forename: Steven M
authors.initials: SM
authors.lastname: Paul
authors.forename: Bradley E
authors.initials: BE
authors.lastname: Aouizerat
authors.forename: Laura
authors.initials: L
authors.lastname: Dunn
authors.forename: Charles
authors.initials: C
authors.lastname: Elboim
authors.forename: Brian
authors.initials: B
authors.lastname: Schmidt
authors.forename: Deborah
authors.initials: D
authors.lastname: Hamolsky
authors.forename: Jon D
authors.initials: JD
authors.lastname: Levine
authors.forename: Gary
authors.initials: G
authors.lastname: Abrams
authors.forename: Judy
authors.initials: J
authors.lastname: Mastick
authors.forename: Kimberly
authors.initials: K
authors.lastname: Topp
authors.forename: Christine
authors.initials: C
authors.lastname: Miaskowski
mesh_terms: D000367:Age Factors; D001365:Axilla; D001943:Breast Neoplasms / Q000503:physiopathology* / Q000628:therapy; D017024:Chemotherapy, Adjuvant; D005260:Female; D018737:Hand Strength / Q000502:physiology*; D006801:Humans; D008137:Longitudinal Studies; D008197:Lymph Node Excision; D016462:Mammaplasty; D008408:Mastectomy; D059373:Mastodynia / Q000503:physiopathology; D008875:Middle Aged; D020360:Neoadjuvant Therapy; D011183:Postoperative Complications / Q000503:physiopathology; D011446:Prospective Studies; D044469:Racial Groups; D016059:Range of Motion, Articular / Q000502:physiology*; D034941:Upper Extremity / Q000503:physiopathology*
references.citation: Breast. 2013 Jun;22(3):273-6
references.pmid: 22858121
references.citation: Arch Intern Med. 2011 Jun 27;171(12):1119-21
references.pmid: 21709116
references.citation: Pain. 1983 Oct;17(2):197-210
references.pmid: 6646795
references.citation: N Am J Sports Phys Ther. 2010 Sep;5(3):98-110
references.pmid: 21589666
references.citation: Breast Cancer Res Treat. 2010 Feb;120(1):135-47
references.pmid: 20054643
references.citation: Eur J Oncol Nurs. 2014 Jun;18(3):242-53
references.pmid: 24485012
references.citation: Eur J Oncol Nurs. 2013 Apr;17(2):190-5
references.pmid: 22892272
references.citation: JAMA Surg. 2015 Jan;150(1):9-16
references.pmid: 25408966
references.citation: Tumori. 2014 Jan-Feb;100(1):87-90
references.pmid: 24675497
references.citation: J Cancer Surviv. 2011 Mar;5(1):62-72
references.pmid: 20972640
references.citation: Breast Cancer Res Treat. 2014 Jul;146(1):109-16
references.pmid: 24816806
references.citation: Ann Surg Oncol. 2004 Nov;11(11):1018-24
references.pmid: 15525832
references.citation: J Physiother. 2014 Dec;60(4):189-200
references.pmid: 25443649
references.citation: Support Care Cancer. 2015 Jun;23(6):1807-17
references.pmid: 25471182
references.citation: CA Cancer J Clin. 2013 Sep;63(5):295-317
references.pmid: 23856764
references.citation: Ann Oncol. 1995 May;6(5):453-9
references.pmid: 7669710
references.citation: J Geriatr Phys Ther. 2008;31(1):3-10
references.pmid: 18489802
references.citation: Breast Cancer Res Treat. 2012 Jul;134(1):315-24
references.pmid: 22527107
references.citation: Ann Intern Med. 1997 Nov 1;127(9):813-6
references.pmid: 9382402
references.citation: Support Care Cancer. 2005 Nov;13(11):904-11
references.pmid: 15812652
references.citation: Arthritis Rheum. 2003 Apr 15;49(2):156-63
references.pmid: 12687505
references.citation: Br J Surg. 2003 Jan;90(1):76-81
references.pmid: 12520579
references.citation: J Clin Oncol. 2009 Jan 20;27(3):390-7
references.pmid: 19064976
references.citation: J Cancer Surviv. 2010 Jun;4(2):167-78
references.pmid: 20373044
references.citation: J Hand Ther. 1999 Jan-Mar;12(1):25-30
references.pmid: 10192632
references.citation: Cancer. 2015 Mar 1;121(5):790-9
references.pmid: 25369150
references.citation: PLoS One. 2014 May 09;9(5):e96748
references.pmid: 24816774
references.citation: Pain. 1995 May;61(2):277-84
references.pmid: 7659438
references.citation: J Pain. 2012 Dec;13(12):1172-87
references.pmid: 23182226
references.citation: Breast Cancer Res Treat. 2013 May;139(1):125-34
references.pmid: 23588950
references.citation: Br J Cancer. 1996 Dec;74(12):2024-31
references.pmid: 8980408
references.citation: Arch Phys Med Rehabil. 2014 May;95(5):875-81
references.pmid: 24389401
references.citation: PLoS One. 2013 Apr 16;8(4):e60164
references.pmid: 23613720