School of Public Health, Queensland University of Technology, Victoria Park Road, Kelvin Grove, Queensland, 4059, Australia.
Health Qual Life Outcomes. 2010 Aug 31;8:92. doi: 10.1186/1477-7525-8-92.
Impairments in upper-body function (UBF) are common following breast cancer. However, the relationship between arm morbidity and quality of life (QoL) remains unclear. This investigation uses longitudinal data to describe UBF in a population-based sample of women with breast cancer and examines its relationship with QoL.
Australian women (n=287) with unilateral breast cancer were assessed at three-monthly intervals, from six- to 18-months post-surgery (PS). Strength, endurance and flexibility were used to assess objective UBF, while the Disability of the Arm, Shoulder and Hand questionnaire and the Functional Assessment of Cancer Therapy-Breast questionnaire were used to assess self-reported UBF and QoL, respectively.
Although mean UBF improved over time, up to 41% of women revealed declines in UBF between six- and 18-months PS. Older age, lower socioeconomic position, treatment on the dominant side, mastectomy, more extensive lymph node removal and having lymphoedema each increased odds of declines in UBF by at least two-fold (p<0.05). Lower baseline and declines in perceived UBF between six- and 18-months PS were each associated with poorer QoL at 18-months PS (p<0.05).
Significant upper-body morbidity is experienced by many following breast cancer treatment, persisting longer term, and adversely influencing the QoL of breast cancer survivors.
乳腺癌患者常出现上肢功能（UBF）障碍。然而，手臂发病与生活质量（QoL）之间的关系尚不清楚。本研究采用纵向数据描述了乳腺癌患者人群中 UBF 的情况，并探讨了其与 QoL 的关系。
对 287 名单侧乳腺癌澳大利亚女性患者进行评估，从术后 6 至 18 个月，每三个月评估一次。采用力量、耐力和柔韧性来评估客观 UBF，而手臂残疾、肩手问卷和癌症治疗功能评估-乳房问卷分别用于评估自我报告的 UBF 和 QoL。
尽管 UBF 均值随时间推移而改善，但仍有 41%的女性在术后 6 至 18 个月期间 UBF 下降。年龄较大、社会经济地位较低、优势侧治疗、乳房切除术、淋巴结清扫范围较广和淋巴水肿的女性，UBF 下降的几率至少增加了两倍（p<0.05）。在术后 6 至 18 个月时，感知 UBF 的基线水平较低和下降，与术后 18 个月时的 QoL 较差相关（p<0.05）。
许多乳腺癌患者在治疗后会出现明显的上肢发病，长期持续存在，并对乳腺癌幸存者的 QoL 产生不利影响。
