Black Breast Cancer Survivors Experience Greater Upper Extremity Disability
Identifieur interne : 002074 ( Main/Exploration ); précédent : 002073; suivant : 002075Black Breast Cancer Survivors Experience Greater Upper Extremity Disability
Auteurs : Lorraine T. Dean ; Angela Demichele ; Mously Leblanc ; Alisa Stephens-Shields ; Susan Q. Li ; Chris Colameco ; Morgan Coursey ; Jun J. MaoSource :
- Breast cancer research and treatment [ 0167-6806 ] ; 2015.
Abstract
Over one third of breast cancer survivors experience upper extremity disability. Black women present with factors associated with greater upper extremity disability, including: increased body mass index (BMI), more advanced disease stage at diagnosis, and varying treatment type compared with Whites. No prior research has evaluated the relationship between race and upper extremity disability using validated tools and controlling for these factors.
Data were drawn from a survey study among 610 women with stage I–III hormone receptor positive breast cancer. The QuickDASH (Disabilities of the Arm, Shoulder and Hand) is an 11-item self-administered questionnaire that has been validated for breast cancer survivors to assess global upper extremity function over the past 7 days. Linear regression and mediation analysis estimated the relationships between race, BMI and QuickDASH score, adjusting for demographics and treatment types.
Black women (n=98) had 7.3 points higher average QuickDASH scores than White (n=512) women (p<0.001). After adjusting for BMI, age, education, cancer treatment, months since diagnosis, and aromatase inhibitor status, Black women had an average 4-point (95% confidence interval: 0.18–8.01) higher QuickDASH score (p=0.04) than White women. Mediation analysis suggested that BMI attenuated the association between race and disability by 40%.
Even several years post-treatment, Black breast cancer survivors had greater upper extremity disability, which was partially mediated by higher BMIs. Close monitoring of high BMI Black women may be an important step in reducing disparities in cancer survivorship. More research is needed on the relationship between race, BMI, and upper extremity disability.
Url:
DOI: 10.1007/s10549-015-3580-3
PubMed: 26420404
PubMed Central: 4623964
Affiliations:
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<author><name sortKey="Demichele, Angela" sort="Demichele, Angela" uniqKey="Demichele A" first="Angela" last="Demichele">Angela Demichele</name>
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<wicri:noCountry code="subfield">University of Pennsylvania School of Medicine</wicri:noCountry>
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<affiliation><nlm:aff id="A2">Abramson Cancer Center, University of Pennsylvania</nlm:aff>
<wicri:noCountry code="subfield">University of Pennsylvania</wicri:noCountry>
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<author><name sortKey="Leblanc, Mously" sort="Leblanc, Mously" uniqKey="Leblanc M" first="Mously" last="Leblanc">Mously Leblanc</name>
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<author><name sortKey="Stephens Shields, Alisa" sort="Stephens Shields, Alisa" uniqKey="Stephens Shields A" first="Alisa" last="Stephens-Shields">Alisa Stephens-Shields</name>
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<wicri:noCountry code="subfield">University of Pennsylvania</wicri:noCountry>
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<author><name sortKey="Colameco, Chris" sort="Colameco, Chris" uniqKey="Colameco C" first="Chris" last="Colameco">Chris Colameco</name>
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<wicri:noCountry code="subfield">University of Pennsylvania</wicri:noCountry>
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<author><name sortKey="Mao, Jun J" sort="Mao, Jun J" uniqKey="Mao J" first="Jun J." last="Mao">Jun J. Mao</name>
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<wicri:noCountry code="subfield">University of Pennsylvania School of Medicine</wicri:noCountry>
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<affiliation><nlm:aff id="A2">Abramson Cancer Center, University of Pennsylvania</nlm:aff>
<wicri:noCountry code="subfield">University of Pennsylvania</wicri:noCountry>
</affiliation>
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<wicri:noCountry code="subfield">University of Pennsylvania</wicri:noCountry>
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<series><title level="j">Breast cancer research and treatment</title>
<idno type="ISSN">0167-6806</idno>
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<front><div type="abstract" xml:lang="en"><sec id="S1"><title>Purpose</title>
<p id="P1">Over one third of breast cancer survivors experience upper extremity disability. Black women present with factors associated with greater upper extremity disability, including: increased body mass index (BMI), more advanced disease stage at diagnosis, and varying treatment type compared with Whites. No prior research has evaluated the relationship between race and upper extremity disability using validated tools and controlling for these factors.</p>
</sec>
<sec id="S2"><title>Methods</title>
<p id="P2">Data were drawn from a survey study among 610 women with stage I–III hormone receptor positive breast cancer. The QuickDASH (Disabilities of the Arm, Shoulder and Hand) is an 11-item self-administered questionnaire that has been validated for breast cancer survivors to assess global upper extremity function over the past 7 days. Linear regression and mediation analysis estimated the relationships between race, BMI and QuickDASH score, adjusting for demographics and treatment types.</p>
</sec>
<sec id="S3"><title>Results</title>
<p id="P3">Black women (n=98) had 7.3 points higher average QuickDASH scores than White (n=512) women (p<0.001). After adjusting for BMI, age, education, cancer treatment, months since diagnosis, and aromatase inhibitor status, Black women had an average 4-point (95% confidence interval: 0.18–8.01) higher QuickDASH score (p=0.04) than White women. Mediation analysis suggested that BMI attenuated the association between race and disability by 40%.</p>
</sec>
<sec id="S4"><title>Conclusions</title>
<p id="P4">Even several years post-treatment, Black breast cancer survivors had greater upper extremity disability, which was partially mediated by higher BMIs. Close monitoring of high BMI Black women may be an important step in reducing disparities in cancer survivorship. More research is needed on the relationship between race, BMI, and upper extremity disability.</p>
</sec>
</div>
</front>
</TEI>
<affiliations><list></list>
<tree><noCountry><name sortKey="Colameco, Chris" sort="Colameco, Chris" uniqKey="Colameco C" first="Chris" last="Colameco">Chris Colameco</name>
<name sortKey="Coursey, Morgan" sort="Coursey, Morgan" uniqKey="Coursey M" first="Morgan" last="Coursey">Morgan Coursey</name>
<name sortKey="Dean, Lorraine T" sort="Dean, Lorraine T" uniqKey="Dean L" first="Lorraine T." last="Dean">Lorraine T. Dean</name>
<name sortKey="Demichele, Angela" sort="Demichele, Angela" uniqKey="Demichele A" first="Angela" last="Demichele">Angela Demichele</name>
<name sortKey="Leblanc, Mously" sort="Leblanc, Mously" uniqKey="Leblanc M" first="Mously" last="Leblanc">Mously Leblanc</name>
<name sortKey="Li, Susan Q" sort="Li, Susan Q" uniqKey="Li S" first="Susan Q." last="Li">Susan Q. Li</name>
<name sortKey="Mao, Jun J" sort="Mao, Jun J" uniqKey="Mao J" first="Jun J." last="Mao">Jun J. Mao</name>
<name sortKey="Stephens Shields, Alisa" sort="Stephens Shields, Alisa" uniqKey="Stephens Shields A" first="Alisa" last="Stephens-Shields">Alisa Stephens-Shields</name>
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