Menopausal-Related Symptoms in Women One Year After Breast Cancer Surgery.

CONTEXT: Approximately 60% to 100% of women with breast cancer experience at least one menopausal-related symptom. Little is known about associations between menopausal status and symptoms in women 12 months after breast cancer surgery. OBJECTIVES: The purpose of this study was to evaluate for differences in occurrence, severity, and distress of symptoms between pre- and postmenopausal women 12 months after breast cancer surgery. METHODS: Women with breast cancer (n = 327) completed the Menopausal Symptoms Scale, which evaluated the occurrence, severity, and distress of 46 common menopausal-related symptoms. Regression analyses were used to evaluate between-group differences in the seven symptoms that occurred in 30% and more of the sample (i.e., hot flashes, night sweats, depression, daytime sweats, joint pain or stiffness, wake during the night, and numbness or tingling). RESULTS: Of the 327 patients with breast cancer, who completed the 12-month assessment, 35.2% were premenopausal and 64.8% were postmenopausal before surgery. In the conditional models, when significant interactions were found, the differences in symptom occurrence rates between pre- and postmenopausal patients depended on their age. CONCLUSION: Regardless of menopausal status, women reported relatively high occurrence rates for several menopausal symptoms. Associations between symptom occurrence rates and menopausal status depended on the patient\u27s age. During the development of a survivorship care plan, clinicians need to assess symptom burden within the context of a woman\u27s menopausal status and salient demographic and clinical characteristics. This approach will assist with the prescription of more effective interventions

Upper extremity impairments in women with or without lymphedema following breast cancer treatment

Breast-cancer-related lymphedema affects ∼25% of breast cancer (BC) survivors and may impact use of the upper limb during activity. The purpose of this study is to compare upper extremity (UE) impairment and activity between women with and without lymphedema after BC treatment. 144 women post BC treatment completed demographic, symptom, and Disability of Arm-Shoulder-Hand (DASH) questionnaires. Objective measures included Purdue pegboard, finger-tapper, Semmes-Weinstein monofilaments, vibration perception threshold, strength, range of motion (ROM), and volume. Women with lymphedema had more lymph nodes removed (p < .001), more UE symptoms (p < .001), higher BMI (p = .041), and higher DASH scores (greater limitation) (p < .001). For all participants there was less strength (elbow flexion, wrist flexion, grip), less shoulder ROM, and decreased sensation at the medial upper arm (p < .05) in the affected UE. These differences were greater in women with lymphedema, particularly in shoulder abduction ROM (p < .05). Women with lymphedema had bilaterally less elbow flexion strength and shoulder ROM (p < .05). Past diagnosis of lymphedema, grip strength, shoulder abduction ROM, and number of comorbidities contributed to the variance in DASH scores (R 2 of 0.463, p < .001). UE impairments are found in women following treatment for BC. Women with lymphedema have greater UE impairment and limitation in activities than women without. Many of these impairments are amenable to prevention measures or treatment, so early detection by health care providers is essential

Upper Extremity Function Following Treatment for Breast Cancer

BACKGROUND: Breast-cancer-related lymphedema affects ~25% of the 2 million breast cancer survivors in the US and may impact function and quality of life. PURPOSE: 1) To compare upper extremity (UE) function between women with and without lymphedema after breast cancer treatment; 2) To determine the impact of impairments on arm function and quality of life (QOL). SUBJECTS: 144 women post breast cancer treatment, 73 diagnosed with lymphedema. METHODS/MATERIALS: Demographic, symptom, Disability of Arm-Shoulder-Hand (DASH), and QOL questionnaires were completed. Objective measures included Purdue pegboard, finger tapper, Semmes-Weinstein monofilaments, vibration perception threshold, strength, range of motion (ROM), and volume. ANALYSIS: T-tests, Mann-Whitney ranked sum analysis, and chi square for significance of differences between groups were performed. Analysis-of-variance was carried out for within and between group comparisons. Linear regression was used to assess the contribution of variables to the variance in DASH and QOL scores. RESULTS: Women with lymphedema had more lymph nodes removed (p < .001), more frequent reports of UE symptoms (p< .001), higher BMI (p =.041), and higher DASH scores (greater disability) (p < .001). There were no differences in QOL scores between groups. For all participants there was less strength (elbow flexion, wrist flexion, grip), less shoulder ROM (abduction, flexion, ER), decreased sensation at the medial upper arm, and greater volume in the affected arm (p < .05). The differences between sides were greater in the women with lymphedema, particularly in shoulder abduction ROM. (p < .05). Women with lymphedema had bilaterally less elbow flexion strength and shoulder ROM (flexion, abduction, ER) (p < .05). Variables found to significantly contribute to the variance of the DASH scores were past diagnosis of lymphedema, affected UE grip strength, affected UE shoulder abduction ROM, and number of comorbidities (R 0.681, R2 of 0.463, p < .001). Age and number of comorbidities explained 33% of the variance in the QOL total score. Affected UE summed strength score contributed to the variance in 3 QOL subscale scores: physical (16%), psychological (8%), and social (11%). CONCLUSIONS: Women with lymphedema have greater UE impairment than women without, which negatively impacts arm function

Upper extremity function following treatment for breast cancer

Background. Breast-cancer-related lymphedema affects ∼25% of the 2 million breast cancer survivors in the US and may impact function and quality of life. Purpose. (1) To compare upper extremity (UE) function between women with and without lymphedema after breast cancer treatment; (2) To determine the impact of impairments on arm function and quality of life (QOL). Subjects. 144 women post breast cancer treatment, 73 diagnosed with lymphedema. Methods/materials. Demographic, symptom, Disability of Arm-Shoulder-Hand (DASH), and QOL questionnaires were completed. Objective measures included Purdue pegboard, finger tapper, Semmes-Weinstein monofilaments, vibration perception threshold, strength, range of motion (ROM), and volume. Analysis. T-tests, Mann-Whitney ranked sum analysis, and chi square for significance of differences between groups were performed. Analysis-of-variance was carried out for within and between group comparisons. Linear regression was used to assess the contribution of variables to the variance in DASH and QOL scores. Results. Women with lymphedema had more lymph nodes removed (p < .001), more frequent reports of UE symptoms (p < .001), higher BMI (p = .041), and higher DASH scores (greater disability) (p < .001). There were no differences in QOL scores between groups. For all participants there was less strength (elbow flexion, wrist flexion, grip), less shoulder ROM (abduction, flexion, ER), decreased sensation at the medial upper arm, and greater volume in the affected arm (p < .05). The differences between sides were greater in the women with lymphedema, particularly in shoulder abduction ROM. (p < .05). Women with lymphedema had bilaterally less elbow flexion strength and shoulder ROM (flexion, abduction, ER) (p < .05). Variables found to significantly contribute to the variance of the DASH scores were past diagnosis of lymphedema, affected UE grip strength, affected UE shoulder abduction ROM, and number of comorbidities (R 0.681, R2 of 0.463, p < .001). Age and number of comorbidities explained 33% of the variance in the QOL total score. Affected UE summed strength score contributed to the variance in 3 QOL subscale scores: physical (16%), psychological (8%), and social (11%). Conclusions. Women with lymphedema have greater UE impairment than women without, which negatively impacts arm function