Journal Article

A longitudinal analysis of chronic arm morbidity following breast cancer surgery

Miedema, Baukje, Tilley, Andrea, Thomas, Roanne L., Boquiren, Virginia M., Hack, Thomas F., Kwan, Winkle B., Quinlan, Elizabeth, Towers, Anna

2016

Overview

Arm morbidity (AM) arising from breast cancer (BC) treatment can detrimentally impact quality of life; often limiting a survivor’s ability to participate in valued activities. The present study explored (a) the developmental time course of AM [restricted range of motion (ROM), pain, and arm volume changes], negative affect, and perceived disability in the immediate years post-surgery, and (b) the mediating role of perceived disability on the relationship between AM and negative affect over time. In this 5-year longitudinal study, BC survivors from four Canadian oncology clinics ( n  = 431) completed five annual clinical assessments, where differences in ROM (shoulder abduction, external rotation) and arm volume between the affected and non-affected arm were measured. The profile of mood states (POMS), disability of arm, shoulder, hand, and McGill Pain Questionnaire-Short form were completed. Results from general linear modeling showed that AM, negative affect, and perceived disability were greatest 1-year post-surgery, declined, and with the exception of arm volume changes, were significantly lower 5 years later. Negative affect was significantly associated with restrictions in shoulder abduction and external rotation (average r  = −0.15; p  < 0.05) and present arm pain (average r  = 0.28, p  < 0.01) at most assessments. The mediating role of perceived disability on the relationship between AM and negative affect was statistically significant in a majority of assessments. Perceived disability is the underlying factor driving the relationship between AM and mood disturbance over time. Rehabilitative therapy to improve survivors’ functional well-being might mitigate the negative impacts of AM on emotional health.

• Publisher: Springer US,Springer Nature B.V
• Subject: Activities of Daily Living - psychology / Adult / Aged / Aged, 80 and over / Analysis / Arm - physiopathology / Arms / Breast cancer / Breast Neoplasms - surgery / Canada - epidemiology / Cancer research / Cancer surgery / Cancer therapies / Female / Humans / Longitudinal Studies / Lymphedema - epidemiology / Lymphedema - etiology / Lymphedema - physiopathology / Lymphedema - psychology / Mastectomy - adverse effects / Medicine / Medicine & Public Health / Middle Aged / Oncology / Pain / Pain - epidemiology / Pain - etiology / Pain - physiopathology / Pain Measurement / Preclinical Study / Prevalence / Quality of Life / Range of Motion, Articular / Surveys and Questionnaires / Survivors - psychology