Journal
BREAST CANCER RESEARCH AND TREATMENT
Volume 79, Issue 1, Pages 47-57Publisher
KLUWER ACADEMIC PUBL
DOI: 10.1023/A:1023330206021
Keywords
arm dysfunction; axilla surgery; breast cancer; EORTC; quality of life
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No long term prospective study has investigated arm morbidity and patient quality of life. It is unclear to what extent breast cancer patients suffer from arm problems, how long such problems affect their lives, and whether quality of life improves as arm problems abate. This prospective cohort study aims to provide data on the clinical factors associated with arm dysfunction, to estimate its prevalence and to relate arm morbidity to quality of life. The Munich Cancer Registry records clinical details of all cancer patients in and around Munich. Quality of life information was provided directly by breast cancer patients (n = 990) over 5 years. Arm morbidity, including movement limitations, swelling and lymph drainage, and quality of life ( EORTC QLQ-C30) were assessed. Up to 5 years after diagnosis, 38% of patients were still experiencing arm problems ( swelling and limited movement). Consistently over the 5 years, quality of life was significantly ( p < 0.001) lower for patients with arm difficulties. For those whose arm problems dissipated, quality of life significantly improved ( p < 0.01). A logistic regression analysis showed that extent of axilla surgery ( p < 0.003), comorbidity (CVD and diabetes) ( p < 0.003), employment ( p < 0.01), younger age ( p < 0.02), and operating clinic ( p < 0.05) significantly contributed to arm problems. Axilla surgery should be re-evaluated since arm morbidity has such a profound effect on patient quality of life.
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