The risk factors and prevalence of upper extremity impairments and an analysis of effects of lymphoedema and other impairments on the quality of life of breast cancer patients

Eur J Cancer Care (Engl). 2017 Jul;26(4). doi: 10.1111/ecc.12433. Epub 2016 Jan 13.

Abstract

This study aimed to determine the prevalence and identify the risk factors associated with upper extremity impairments (UEIs) in breast cancer patients and to investigate the degree to which these impairments and other characteristics influence quality of life (QoL). A total of 201 women over the age of 18 who underwent breast cancer treatment at least 6 months were included in this cross-sectional study. All of the patients were evaluated for the presence of lymphoedema and any UEIs. UEIs divided into five subgroups: pain, restriction of shoulder range of motion (ROM), numbness and heaviness, loss of strength, and sensory deficit. QoL of the patients was evaluated by SF-36. The prevalence of the upper extremity impairments was as follows: pain 31.8%, restriction of shoulder ROM 23.9%, numbness and heaviness 35.3%, loss of strength 8.5%, and sensory deficit 18.4%. Furthermore, lymphoedema was seen in 41.3% of patients. The multivariate model showed that lymphoedema is the only statistically significant risk factor that affects the development of UEIs (P = 0.001). However, it also revealed that lymphoedema (P = 0.001) and increased age negatively affect QoL, whereas prolongation of the follow-up period has a favourable impact (P = 0.016). Therefore, lymphoedema diminishes QoL via an increased number of UEIs.

Keywords: breast cancer; lymphoedema; prevalence; quality of life; upper extremity impairment.

MeSH terms

  • Adult
  • Aged
  • Antineoplastic Agents / therapeutic use
  • Breast Neoplasms / complications
  • Breast Neoplasms / therapy*
  • Combined Modality Therapy
  • Cross-Sectional Studies
  • Female
  • Humans
  • Hypesthesia / etiology
  • Lymphedema / complications*
  • Mastectomy, Radical / methods
  • Middle Aged
  • Muscle Strength / physiology
  • Muscle, Skeletal / physiology
  • Musculoskeletal Pain / etiology
  • Quality of Life*
  • Range of Motion, Articular / physiology
  • Risk Factors
  • Sensation Disorders / etiology
  • Upper Extremity

Substances

  • Antineoplastic Agents