Journal article
Upper extremity disability and quality of life after breast cancer treatment in the Greater Plains Collaborative clinical research network
Breast cancer research and treatment, Vol.175(3), pp.675-689
06/2019
DOI: 10.1007/s10549-019-05184-1
PMCID: PMC6534523
PMID: 30852760
Abstract
Chronic upper extremity disability (UED) is common after breast cancer treatment but under-identified and under-treated. Although UED has been linked to quality of life (QoL), the role of UED as mediator between contemporary treatment practices and QoL has not been quantified. This investigation describes UED in a contemporary sample of breast cancer patients and examines its relationship with personal and treatment factors and QoL.
Eight hundred and thirty-three women diagnosed at eight medical institutions during 2013-2014 with microscopically confirmed ductal carcinoma in situ or invasive stage I-III breast cancer were surveyed an average of 22 months after diagnosis. UED was measured with a modified QuickDASH and QoL with the FACT-B. The questionnaire also collected treatments, sociodemographic information, comorbidity, body mass index, and a 3-item health literacy screener.
Women who received post-mastectomy radiation and chemotherapy experienced significantly worse UED and QoL. Women who had lower income, lower health literacy and prior diabetes, arthritis or shoulder diagnoses had worse UED. Patients with worse UED reported significantly worse QoL. Income and health literacy were independently associated with QoL after adjustment for UED but treatment and prior conditions were not, indicating mediation by UED. UED mediated 52-79% of the effect of mastectomy-based treatments on QoL as compared with unilateral mastectomy without radiation. UED and QoL did not differ by type of axillary surgery or post-mastectomy reconstruction.
A large portion of treatment effect on QoL is mediated by UED. Rehabilitation practices that prevent and alleviate UED are likely to improve QoL for breast cancer survivors.
Details
- Title: Subtitle
- Upper extremity disability and quality of life after breast cancer treatment in the Greater Plains Collaborative clinical research network
- Creators
- Elizabeth A Chrischilles - College of Public Health, University of Iowa, S424 CPHB, 145 N. Riverside Dr., Iowa City, IA, 52242-2007, USA. e-chrischilles@uiowa.eduDanielle Riley - University of Iowa College of Public Health, Iowa City, IA, USAElena Letuchy - University of Iowa College of Public Health, Iowa City, IA, USALinda Koehler - University of Minnesota, Minneapolis, MN, USAJoan Neuner - Medical College of Wisconsin, Milwaukee, WI, USACheryl Jernigan - University of Kansas Medical Center, Kansas City, KS, USABrian Gryzlak - University of Iowa College of Public Health, Iowa City, IA, USANeil Segal - University of Kansas Medical Center, Kansas City, KS, USABradley McDowell - University of Iowa Holden Comprehensive Cancer Center, Iowa City, IA, USABrian Smith - University of Iowa Holden Comprehensive Cancer Center, Iowa City, IA, USASonia L Sugg - University of Iowa Carver College of Medicine, Iowa City, IA, USAJane M Armer - University of Missouri Sinclair School of Nursing, Columbia, MO, USAIngrid M Lizarraga - University of Iowa Carver College of Medicine, Iowa City, IA, USA
- Resource Type
- Journal article
- Publication Details
- Breast cancer research and treatment, Vol.175(3), pp.675-689
- DOI
- 10.1007/s10549-019-05184-1
- PMID
- 30852760
- PMCID
- PMC6534523
- NLM abbreviation
- Breast Cancer Res Treat
- ISSN
- 1573-7217
- eISSN
- 1573-7217
- Publisher
- Netherlands
- Grant note
- P30 CA086862 / NIH HHS UL1 TR002537 / NCATS NIH HHS CDRN-1306-04631 / Patient-Centered Outcomes Research Institute P30 CA086862 / NCI NIH HHS
- Language
- English
- Date published
- 06/2019
- Academic Unit
- Pharmacy; Epidemiology; Biostatistics; Surgery; Holden Comprehensive Cancer Center
- Record Identifier
- 9983995005302771
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