The impact of breast cancer-related lymphedema on the ability to perform upper extremity activities of daily living.
Identifieur interne : 001716 ( Main/Exploration ); précédent : 001715; suivant : 001717The impact of breast cancer-related lymphedema on the ability to perform upper extremity activities of daily living.
Auteurs : Jean A. O'Toole [États-Unis] ; Chantal M. Ferguson ; Meyha N. Swaroop ; Nora Horick ; Melissa N. Skolny ; Cheryl L. Brunelle ; Cynthia L. Miller ; Lauren S. Jammallo ; Michelle C. Specht ; Alphonse G. TaghianSource :
- Breast cancer research and treatment [ 1573-7217 ] ; 2015.
Descripteurs français
- KwdFr :
- Activité motrice, Activités de la vie quotidienne, Adulte, Adulte d'âge moyen, Bras (anatomopathologie), Bras (physiopathologie), Femelle, Humains, Lymphoedème (physiopathologie), Lymphoedème (étiologie), Mastectomie, Qualité de vie, Sujet âgé, Sujet âgé de 80 ans ou plus, Tumeurs du sein (), Tumeurs du sein (anatomopathologie), Études prospectives.
- MESH :
- anatomopathologie : Bras, Tumeurs du sein.
- physiopathologie : Bras, Lymphoedème.
- étiologie : Lymphoedème.
- Activité motrice, Activités de la vie quotidienne, Adulte, Adulte d'âge moyen, Femelle, Humains, Mastectomie, Qualité de vie, Sujet âgé, Sujet âgé de 80 ans ou plus, Tumeurs du sein, Études prospectives.
English descriptors
- KwdEn :
- Activities of Daily Living, Adult, Aged, Aged, 80 and over, Arm (pathology), Arm (physiopathology), Breast Neoplasms (complications), Breast Neoplasms (pathology), Breast Neoplasms (surgery), Female, Humans, Lymphedema (etiology), Lymphedema (physiopathology), Mastectomy, Middle Aged, Motor Activity, Prospective Studies, Quality of Life.
- MESH :
- complications : Breast Neoplasms.
- etiology : Lymphedema.
- pathology : Arm, Breast Neoplasms.
- physiopathology : Arm, Lymphedema.
- surgery : Breast Neoplasms.
- Activities of Daily Living, Adult, Aged, Aged, 80 and over, Female, Humans, Mastectomy, Middle Aged, Motor Activity, Prospective Studies, Quality of Life.
Abstract
We sought to assess the association of breast cancer-related lymphedema (BCRL) with the ability to perform upper extremity activities of daily living (ADL) in our patient population. 324 breast cancer patients who had received treatment for unilateral breast cancer at our institution between 2005 and 2014 were prospectively screened for lymphedema. Bilateral arm measurements were performed pre-operatively and during post-operative follow-up using a Perometer. Patients completed an extensive quality of life (QOL) questionnaire at the time of each study assessment. Lymphedema was defined as a relative volume change (RVC) of ≥10% from the patient's pre-operative baseline measurement. Linear regression models were used to evaluate the relationship between post-operative arm function score (as a continuous variable) and RVC, demographic, clinical, and QOL factors. By multivariate analysis, greater fear of lymphedema (p < 0.0001), more pain (p < 0.0001), body mass index >25 (p = 0.0015), mastectomy (p = 0.0001), and having an axillary node dissection (p = 0.0045) were all associated with lower functional scores. Higher emotional well-being score (p < 0.0001) and adjuvant chemotherapy (p = 0.0005) were associated with higher post-operative functional score. Neither low-level volume changes (5-10 % RVC) nor BCRL (RVC ≥10 %) were associated with ability to perform upper extremity ADL as measured by self-report (p = 0.99, p = 0.79). This prospective study demonstrates that low-level changes in arm volume (RVC 5-10 %) as well as clinically significant BCRL (RVC ≥10 %) did not impact the self-reported ability to use the affected extremity for ADL. These findings may help to inform clinicians and patients on the importance of prospective screening for lymphedema and QOL which enables early detection and intervention.
DOI: 10.1007/s10549-015-3325-3
PubMed: 25749734
Affiliations:
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Swaroop</name></author><author><name sortKey="Horick, Nora" sort="Horick, Nora" uniqKey="Horick N" first="Nora" last="Horick">Nora Horick</name></author><author><name sortKey="Skolny, Melissa N" sort="Skolny, Melissa N" uniqKey="Skolny M" first="Melissa N" last="Skolny">Melissa N. Skolny</name></author><author><name sortKey="Brunelle, Cheryl L" sort="Brunelle, Cheryl L" uniqKey="Brunelle C" first="Cheryl L" last="Brunelle">Cheryl L. Brunelle</name></author><author><name sortKey="Miller, Cynthia L" sort="Miller, Cynthia L" uniqKey="Miller C" first="Cynthia L" last="Miller">Cynthia L. Miller</name></author><author><name sortKey="Jammallo, Lauren S" sort="Jammallo, Lauren S" uniqKey="Jammallo L" first="Lauren S" last="Jammallo">Lauren S. Jammallo</name></author><author><name sortKey="Specht, Michelle C" sort="Specht, Michelle C" uniqKey="Specht M" first="Michelle C" last="Specht">Michelle C. Specht</name></author><author><name sortKey="Taghian, Alphonse G" sort="Taghian, Alphonse G" uniqKey="Taghian A" first="Alphonse G" last="Taghian">Alphonse G. 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Bilateral arm measurements were performed pre-operatively and during post-operative follow-up using a Perometer. Patients completed an extensive quality of life (QOL) questionnaire at the time of each study assessment. Lymphedema was defined as a relative volume change (RVC) of ≥10% from the patient's pre-operative baseline measurement. Linear regression models were used to evaluate the relationship between post-operative arm function score (as a continuous variable) and RVC, demographic, clinical, and QOL factors. By multivariate analysis, greater fear of lymphedema (p < 0.0001), more pain (p < 0.0001), body mass index >25 (p = 0.0015), mastectomy (p = 0.0001), and having an axillary node dissection (p = 0.0045) were all associated with lower functional scores. Higher emotional well-being score (p < 0.0001) and adjuvant chemotherapy (p = 0.0005) were associated with higher post-operative functional score. Neither low-level volume changes (5-10 % RVC) nor BCRL (RVC ≥10 %) were associated with ability to perform upper extremity ADL as measured by self-report (p = 0.99, p = 0.79). This prospective study demonstrates that low-level changes in arm volume (RVC 5-10 %) as well as clinically significant BCRL (RVC ≥10 %) did not impact the self-reported ability to use the affected extremity for ADL. These findings may help to inform clinicians and patients on the importance of prospective screening for lymphedema and QOL which enables early detection and intervention.</div></front></TEI><affiliations><list><country><li>États-Unis</li></country></list><tree><noCountry><name sortKey="Brunelle, Cheryl L" sort="Brunelle, Cheryl L" uniqKey="Brunelle C" first="Cheryl L" last="Brunelle">Cheryl L. Brunelle</name><name sortKey="Ferguson, Chantal M" sort="Ferguson, Chantal M" uniqKey="Ferguson C" first="Chantal M" last="Ferguson">Chantal M. Ferguson</name><name sortKey="Horick, Nora" sort="Horick, Nora" uniqKey="Horick N" first="Nora" last="Horick">Nora Horick</name><name sortKey="Jammallo, Lauren S" sort="Jammallo, Lauren S" uniqKey="Jammallo L" first="Lauren S" last="Jammallo">Lauren S. Jammallo</name><name sortKey="Miller, Cynthia L" sort="Miller, Cynthia L" uniqKey="Miller C" first="Cynthia L" last="Miller">Cynthia L. Miller</name><name sortKey="Skolny, Melissa N" sort="Skolny, Melissa N" uniqKey="Skolny M" first="Melissa N" last="Skolny">Melissa N. Skolny</name><name sortKey="Specht, Michelle C" sort="Specht, Michelle C" uniqKey="Specht M" first="Michelle C" last="Specht">Michelle C. Specht</name><name sortKey="Swaroop, Meyha N" sort="Swaroop, Meyha N" uniqKey="Swaroop M" first="Meyha N" last="Swaroop">Meyha N. Swaroop</name><name sortKey="Taghian, Alphonse G" sort="Taghian, Alphonse G" uniqKey="Taghian A" first="Alphonse G" last="Taghian">Alphonse G. Taghian</name></noCountry><country name="États-Unis"><noRegion><name sortKey="O Toole, Jean A" sort="O Toole, Jean A" uniqKey="O Toole J" first="Jean A" last="O'Toole">Jean A. O'Toole</name></noRegion></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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