Upper-body morbidity following breast cancer treatment is common, may persist longer-term and adversely influences quality of life

Abstract

Background: Impairments in upper-body function (UBF) are common following breast cancer. However, the
relationship between arm morbidity and quality of life (QoL) remains unclear. This investigation uses longitudinal
data to describe UBF in a population-based sample of women with breast cancer and examines its relationship
with QoL. ----------
Methods: Australian women (n = 287) with unilateral breast cancer were assessed at three-monthly intervals, from
six- to 18-months post-surgery (PS). Strength, endurance and flexibility were used to assess objective UBF, while
the Disability of the Arm, Shoulder and Hand questionnaire and the Functional Assessment of Cancer Therapy-
Breast questionnaire were used to assess self-reported UBF and QoL, respectively. ----------
Results: Although mean UBF improved over time, up to 41% of women revealed declines in UBF between sixand
18-months PS. Older age, lower socioeconomic position, treatment on the dominant side, mastectomy, more
extensive lymph node removal and having lymphoedema each increased odds of declines in UBF by at least twofold
(p < 0.05). Lower baseline and declines in perceived UBF between six- and 18-months PS were each
associated with poorer QoL at 18-months PS (p < 0.05). ----------
Conclusions: Significant upper-body morbidity is experienced by many following breast cancer treatment,
persisting longer term, and adversely influencing the QoL of breast cancer survivors.