Implications of Mobility Impairment on the Diagnosis and Treatment of Breast Cancer
Identifieur interne : 002F22 ( Pmc/Checkpoint ); précédent : 002F21; suivant : 002F23Implications of Mobility Impairment on the Diagnosis and Treatment of Breast Cancer
Auteurs : Lisa I. Iezzoni ; Elyse R. Park ; Kerry L. KilbridgeSource :
- Journal of Women's Health [ 1540-9996 ] ; 2011.
Abstract
Among women with chronic, preexisting mobility impairments, we sought to explore how their mobility difficulties affected the diagnosis and treatment of early-stage breast cancer
This is a qualitative analysis of transcripts from in-depth in-person or telephone interviews with 20 English-speaking women who had early-stage breast cancer, were <60 years of age, and had chronic difficulty walking or used wheeled mobility aids at the time of their breast cancer diagnoses
Nine women were disabled by polio as children or had postpolio syndrome, 3 had cerebral palsy, 3 had spinal cord injury, and 5 had other conditions. Most women reported difficulty obtaining mammograms, primarily because of inaccessible equipment, positioning problems, and difficulties with uncontrollable movements. Many women made decisions about surgical approach and chemotherapy by explicitly considering how various therapies would affect their arms, which are essential to their mobility (they use ambulation aids, self-propel manual wheelchairs, or otherwise rely on their arms for mobility or safety). Managing at home after surgery posed major mobility challenges, especially for women who lived alone. Several women reported feeling they suffered more chemotherapy side effects than do women without mobility problems. Weight gains with endocrine therapy compromised the mobility of several women.
Increasing numbers of American women are living with mobility disabilities and entering age ranges with increased risks of breast cancer. Mobility impairments can affect women at every point during early-stage breast cancer diagnosis, therapy, and recovery. Clinicians must consider women's mobility functioning in making therapeutic recommendations to women with impaired mobility who develop breast cancer.
Url:
DOI: 10.1089/jwh.2009.1831
PubMed: 21034276
PubMed Central: 3052272
Affiliations:
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<author><name sortKey="Iezzoni, Lisa I" sort="Iezzoni, Lisa I" uniqKey="Iezzoni L" first="Lisa I." last="Iezzoni">Lisa I. Iezzoni</name>
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<author><name sortKey="Park, Elyse R" sort="Park, Elyse R" uniqKey="Park E" first="Elyse R." last="Park">Elyse R. Park</name>
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<author><name sortKey="Kilbridge, Kerry L" sort="Kilbridge, Kerry L" uniqKey="Kilbridge K" first="Kerry L." last="Kilbridge">Kerry L. Kilbridge</name>
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<series><title level="j">Journal of Women's Health</title>
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<front><div type="abstract" xml:lang="en"><title>Abstract</title>
<sec><title>Background</title>
<p>Among women with chronic, preexisting mobility impairments, we sought to explore how their mobility difficulties affected the diagnosis and treatment of early-stage breast cancer</p>
</sec>
<sec><title>Methods</title>
<p>This is a qualitative analysis of transcripts from in-depth in-person or telephone interviews with 20 English-speaking women who had early-stage breast cancer, were <60 years of age, and had chronic difficulty walking or used wheeled mobility aids at the time of their breast cancer diagnoses</p>
</sec>
<sec><title>Results</title>
<p>Nine women were disabled by polio as children or had postpolio syndrome, 3 had cerebral palsy, 3 had spinal cord injury, and 5 had other conditions. Most women reported difficulty obtaining mammograms, primarily because of inaccessible equipment, positioning problems, and difficulties with uncontrollable movements. Many women made decisions about surgical approach and chemotherapy by explicitly considering how various therapies would affect their arms, which are essential to their mobility (they use ambulation aids, self-propel manual wheelchairs, or otherwise rely on their arms for mobility or safety). Managing at home after surgery posed major mobility challenges, especially for women who lived alone. Several women reported feeling they suffered more chemotherapy side effects than do women without mobility problems. Weight gains with endocrine therapy compromised the mobility of several women.</p>
</sec>
<sec><title>Conclusions</title>
<p>Increasing numbers of American women are living with mobility disabilities and entering age ranges with increased risks of breast cancer. Mobility impairments can affect women at every point during early-stage breast cancer diagnosis, therapy, and recovery. Clinicians must consider women's mobility functioning in making therapeutic recommendations to women with impaired mobility who develop breast cancer.</p>
</sec>
</div>
</front>
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<pmc article-type="research-article"><pmc-comment>The publisher of this article does not allow downloading of the full text in XML form.</pmc-comment>
<front><journal-meta><journal-id journal-id-type="nlm-ta">J Womens Health (Larchmt)</journal-id>
<journal-id journal-id-type="publisher-id">jwh</journal-id>
<journal-title-group><journal-title>Journal of Women's Health</journal-title>
</journal-title-group>
<issn pub-type="ppub">1540-9996</issn>
<issn pub-type="epub">1931-843X</issn>
<publisher><publisher-name>Mary Ann Liebert, Inc.</publisher-name>
<publisher-loc>140 Huguenot Street, 3rd FloorNew Rochelle, NY 10801USA</publisher-loc>
</publisher>
</journal-meta>
<article-meta><article-id pub-id-type="pmid">21034276</article-id>
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<article-id pub-id-type="publisher-id">10.1089/jwh.2009.1831</article-id>
<article-id pub-id-type="doi">10.1089/jwh.2009.1831</article-id>
<article-categories><subj-group subj-group-type="heading"><subject>Original Articles</subject>
</subj-group>
</article-categories>
<title-group><article-title>Implications of Mobility Impairment on the Diagnosis and Treatment of Breast Cancer</article-title>
</title-group>
<contrib-group><contrib contrib-type="author" corresp="yes"><name><surname>Iezzoni</surname>
<given-names>Lisa I.</given-names>
</name>
<degrees>M.D., M.Sc.</degrees>
<xref ref-type="aff" rid="aff1"><sup>1,</sup>
</xref>
<xref ref-type="aff" rid="aff2"><sup>2</sup>
</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Park</surname>
<given-names>Elyse R.</given-names>
</name>
<degrees>Ph.D., M.P.H.</degrees>
<xref ref-type="aff" rid="aff3"><sup>3</sup>
</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Kilbridge</surname>
<given-names>Kerry L.</given-names>
</name>
<degrees>M.D.</degrees>
<xref ref-type="aff" rid="aff2"><sup>2,</sup>
</xref>
<xref ref-type="aff" rid="aff4"><sup>4</sup>
</xref>
</contrib>
<aff id="aff1"><label><sup>1</sup>
</label>
Mongan Institute for Health Policy,<institution>Massachusetts General Hospital</institution>
, Boston, Massachusetts.</aff>
<aff id="aff2"><label><sup>2</sup>
</label>
Harvard Medical School, Department of Medicine,<institution>Massachusetts General Hospital</institution>
, Boston, Massachusetts.</aff>
<aff id="aff3"><label><sup>3</sup>
</label>
<institution>Massachusetts General Hospital</institution>
, Harvard Medical School, Department of Psychiatry, Boston, Massachusetts.</aff>
<aff id="aff4"><label><sup>4</sup>
</label>
Department of Medicine and Division of Hematology-Oncology,<institution>Massachusetts General Hospital</institution>
, Boston, Massachusetts.</aff>
</contrib-group>
<author-notes><corresp>Address correspondence to: <italic>Lisa I. Iezzoni, M.D., M.Sc., Mongan Institute for Health Policy, Massachusetts General Hospital, 50 Staniford Street, Room 901B, Boston, MA 02114. E-mail:</italic>
<email xlink:href="mailto:liezzoni@partners.org">liezzoni@partners.org</email>
</corresp>
</author-notes>
<pub-date pub-type="ppub"><month>1</month>
<year>2011</year>
<pmc-comment>string-date: January 2011</pmc-comment>
</pub-date>
<volume>20</volume>
<issue>1</issue>
<fpage>45</fpage>
<lpage>52</lpage>
<permissions><copyright-statement>Copyright 2011, Mary Ann Liebert, Inc.</copyright-statement>
</permissions>
<self-uri xlink:type="simple" xlink:href="jwh.2009.1831.pdf"></self-uri>
<abstract><title>Abstract</title>
<sec><title>Background</title>
<p>Among women with chronic, preexisting mobility impairments, we sought to explore how their mobility difficulties affected the diagnosis and treatment of early-stage breast cancer</p>
</sec>
<sec><title>Methods</title>
<p>This is a qualitative analysis of transcripts from in-depth in-person or telephone interviews with 20 English-speaking women who had early-stage breast cancer, were <60 years of age, and had chronic difficulty walking or used wheeled mobility aids at the time of their breast cancer diagnoses</p>
</sec>
<sec><title>Results</title>
<p>Nine women were disabled by polio as children or had postpolio syndrome, 3 had cerebral palsy, 3 had spinal cord injury, and 5 had other conditions. Most women reported difficulty obtaining mammograms, primarily because of inaccessible equipment, positioning problems, and difficulties with uncontrollable movements. Many women made decisions about surgical approach and chemotherapy by explicitly considering how various therapies would affect their arms, which are essential to their mobility (they use ambulation aids, self-propel manual wheelchairs, or otherwise rely on their arms for mobility or safety). Managing at home after surgery posed major mobility challenges, especially for women who lived alone. Several women reported feeling they suffered more chemotherapy side effects than do women without mobility problems. Weight gains with endocrine therapy compromised the mobility of several women.</p>
</sec>
<sec><title>Conclusions</title>
<p>Increasing numbers of American women are living with mobility disabilities and entering age ranges with increased risks of breast cancer. Mobility impairments can affect women at every point during early-stage breast cancer diagnosis, therapy, and recovery. Clinicians must consider women's mobility functioning in making therapeutic recommendations to women with impaired mobility who develop breast cancer.</p>
</sec>
</abstract>
<counts><table-count count="2"></table-count>
<ref-count count="41"></ref-count>
<page-count count="8"></page-count>
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<tree><noCountry><name sortKey="Iezzoni, Lisa I" sort="Iezzoni, Lisa I" uniqKey="Iezzoni L" first="Lisa I." last="Iezzoni">Lisa I. Iezzoni</name>
<name sortKey="Kilbridge, Kerry L" sort="Kilbridge, Kerry L" uniqKey="Kilbridge K" first="Kerry L." last="Kilbridge">Kerry L. Kilbridge</name>
<name sortKey="Park, Elyse R" sort="Park, Elyse R" uniqKey="Park E" first="Elyse R." last="Park">Elyse R. Park</name>
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