Upper extremity function and quality of life in patients with breast cancer related lymphedema

Dragana D. Bojinović-Rodić; Svetlana Popovič-Petrović; Sanja Tomić; Stanislava Markez; Dobrinka Živanić

doi:10.2298/VSP150208075B

Dragana D. Bojinović-Rodić Institute of Physical Medicine and Rehabilitation „dr Miroslav Zotović“ Banja Luka, Bosnia and Hercegovina
Svetlana Popovič-Petrović Rehabilitation Department, Oncology Institute of Vojvodina, Sremska Kamenica, Serbia; Faculty of Medicine, University of Novi Sad, Novi Sad, Serbia
Sanja Tomić Faculty of Medicine, University of Novi Sad, Novi Sad, Serbia
Stanislava Markez Institute of Physical Medicine and Rehabilitation „Dr Miroslav Zotović“, Banja Luka, Republic of Srpska, Bosnia and Herzegovina
Dobrinka Živanić Institute of Physical Medicine and Rehabilitation „Dr Miroslav Zotović“, Banja Luka, Republic of Srpska, Bosnia and Herzegovina

DOI: https://doi.org/10.2298/VSP150208075B

Keywords: breast neoplasms, carcinoma, upper extremity, lymphedema, quality of life,

Abstract

Background/Aim. Upper limb lymphedema is one of the most frequent chronic complications after breast cancer treatment with a significant impact on the upper extremity function and quality of life (QoL). The aim of this study was to estimate health-related quality of life (HRQoL) in patients with breast-cancer-related lymphedema and its correlation with upper limb function and the size of edema. Methods. The cross-sectional study included 54 breast-cancer-related lymphedema patients. The quality of life was evaluated by the Short Form 36-Item Health Survey (SF-36). Upper limb function was assessed by the Quick Disability of the Arm, Shoulder and Hand questionnaire (Quick DASH). The size of lymphedema was determined by the arm circumference. Results. The higher HRQoL score was assessed for mental health (47.0 ± 12.2) than for physical one (42.2 ± 7.5). The highest values of SF-36 were found in the domains of Mental Health (67.7 ± 22.9) and Social Function (70.1 ± 23.1). The lowest scores were registered in the domains of Role Physical (46.9 ± 39.1) and General Health (49.3 ± 20.1). Upper extremity function statistically significantly correlated with the domains Role Physical, Bodily Pain and Physical Composite Summary and also, with the domain Role Emotional (p < 0.01). There was no statistically significant correlation between size of lymphedema and tested domains of quality of life (p > 0.05). Conclusion. Physical disability in patients with breast-cancer-related lymphedema influences quality of life more than mental health. Upper limb function has a significant impact on quality of life, not only on the physical, but also on the mental component. The presence of breast-cancer-related lymphedema certainly affects upper limb function and quality of life, but in this study no significant correlation between the size of edema and quality of life was found.

References

Pinto M, Gimigliano F, Tatangelo F, Megna M, Izzo F, Gimigliano R, et al. Upper limb function and quality of life in breast cancer related lymphedema: a cross-sectional study. Eur J Phys Reha-bil Med 2013; 49(5): 665−73.

Beaulac SM, McNair LA, Scott TE, LaMorte WW, Kavanah MT. Lymphedema and quality of life in survivors of early-stage breast cancer. Arch Surg 2002; 137(11): 1253−7.

Ahmed RL, Prizment A, Lazovich D, Schmitz KH, Folsom AR. Lymphedema and quality of life in breast cancer survivors: the Iowa Women's Health Study. J Clin Oncol 2008; 26(35): 5689−96.

Lee SH, Min Y, Park HY, Jung T. Health-Related Quality of Life in Breast Cancer Patients with Lymphedema Who Sur-vived More than One Year after Surgery. J Breast Cancer 2012; 15(4): 449−53.

McWayne J, Heiney SP. Psychologic and social sequelae of sec-ondary lymphedema: a review. Cancer 2005; 104(3): 457−66.

Smoot B, Wong J, Cooper B, Wanek L, Topp K, Byl N, et al. Upper extremity impairments in women with or without lymphedema following breast cancer treatment. J Cancer Surviv 2010; 4(2): 167−78.

Hayes SC, Johansson K, Stout NL, Prosnitz R, Armer JM, Gabram S, et al. Upper-body morbidity after breast cancer: incidence and evidence for evaluation, prevention, and management within a prospective surveillance model of care. Cancer 2012; 118(Suppl 8): S2237−49.

Park JE, Jang HJ, Seo KS. Quality of life, upper extremity func-tion and the effect of lymphedema treatment in breast cancer related lymphedema patients. Ann Rehabil Med 2012; 36(2): 240−7.

Stubblefield MD, Keole N. Upper body pain and functional dis-orders in patients with breast cancer. PM R 2014; 6(2): 170−83.

Treanor C, Donnelly M. A methodological review of the Short Form Health Survey 36 (SF-36) and its derivatives among breast cancer survivors. Qual Life Res 2015; 24(2): 339−62.

Ware JE, Gandek B, Kosinski M, Aaronson NK, Apolone G, Brazier J, et al. The equivalence of SF-36 summary health scores esti-mated using standard and country-specific algorithms in 10 countries: results from the IQOLA Project. International Quality of Life Assessment. J Clin Epidemiol 1998; 51(11): 1167−70.

le Blanc M, Stineman M, de Michele A, Stricker C, Mao JJ. Validation of QuickDASH outcome measure in breast cancer survivors for upper extremity disability. Arch Phys Med Rehabil 2014; 95(3): 493−8.

Beaton DE, Wright JG, Katz JN. Development of the Quick-DASH: comparison of three item-reduction approaches. J Bone Joint Surg Am 2005; 87(5): 1038−46.

Pusic AL, Cemal Y, Albornoz C, Klassen A, Cano S, Sulimanoff I, et al. Quality of life among breast cancer patients with lymphe-dema: a systematic review of patient-reported outcome in-struments and outcomes. J Cancer Surviv 2012; 7(1): 83−92.

Chachaj A, Małyszczak K, Pyszel K, Lukas J, Tarkowski R, Pudełko M, et al. Physical and psychological impairments of women with upper limb lymphedema following breast cancer treat-ment. Psychooncology 2010; 19(3): 299−305.

Ridner SH. Quality of life and a symptom cluster associated with breast cancer treatment-related lymphedema. Support Care Cancer 2005; 13(11): 904−11.

Pain S, Vowler S, Purushotham A. Is physical function a more appropriate measure than volume excess in the assessment of breast cancer-related lymphoedema (BCRL). Eur J Cancer 2003; 39(15): 2168−72.

Velanovich V, Szymanski W. Quality of life of breast cancer pa-tients with lymphedema. Am J Surg 1999; 177(3): 184−7.

Hormes JM, Bryan C, Lytle LA, Gross CR, Ahmed RL, Troxel AB, et al. Impact of lymphedema and arm symptoms on quality of life in breast cancer survivors. Lymphology 2010; 43(1): 1−13.

Engel J, Kerr J, Schlesinger-Raab A, Eckel R, Sauer H, Hölzel D. Predictors of quality of life of breast cancer patients. Acta On-col 2003; 42(7): 710−8.

Nesvold I, Reinertsen KV, Fosså SD, Dahl AA. The relation be-tween arm/shoulder problems and quality of life in breast cancer survivors: a cross-sectional and longitudinal study. J Cancer Surviv 2011; 5(1): 62−72.

Paim CR, de Paula LE, Fu MR, de Paula LA, Cassali GD. Post lymphadenectomy complications and quality of life among breast cancer patients in Brazil. Cancer Nurs 2008; 31(4): 302−9.

Voogd AC, Ververs JM, Vingerhoets AJ, Roumen RM, Coebergh JW, Crommelin MA. Lymphoedema and reduced shoulder http://aseestant.ceon.rs/index.php/vsp/editor/viewMetadata/7690function as indicators of quality of life after axillary lymph node dissec-tion for invasive breast cancer. Br J Surg 2003; 90(1): 76−81.

Bosompra K, Ashikaga T, O'Brien PJ, Nelson L, Skelly J. Swelling, numbness, pain, and their relationship to arm function among breast cancer survivors: a disablement process model perspec-tive. Breast J 2002; 8(6): 338−48.

Popović-Petrović S, Tomić S, Nedeljković M, Popović L, Matovina G. Early rehabilitation in patients operated for breast carcinoma. Vojnosanit Pregl 2013; 70(4): 407−10.

Bulley C, Gaal S, Coutts F, Blyth C, Jack W, Chetty U, et al. Com-parison of Breast Cancer-Related Lymphedema (Upper Limb Swelling) Prevalence Estimated Using Objective and Subjective Criteria and Relationship with Quality of Life. Biomed Res Int 2013; 2013: 1−8.