National Resource Center for Late Effects, Department of Oncology, Oslo University Hospital and University of Oslo, Oslo, Norway.
J Cancer Surviv. 2011 Mar;5(1):62-72. doi: 10.1007/s11764-010-0156-4. Epub 2010 Oct 23.
This cross-sectional and longitudinal study of breast cancer survivors (BCSs) examines the associations between arm/shoulder problems (ASPs), which consist of pain, restricted mobility and lymphedema, and different aspects of quality of life (QoL).
BCSs who had breast surgery, axillary lymph node dissection and radiotherapy (n = 255) were examined in 2004 (mean 4.1 years post-surgery) and a sub-sample (n = 187) was re-examined in 2007. ASPs was rated clinically in 2004 and by self-report (EORTC BR23) in 2004 and 2007. QoL was self-reported with The Short Form-36 (SF-36) and The Impact of Cancer scale (IOC).
In 2004 BCSs with ASPs showed significantly poorer mean scores in most SF-36 domains compared to those without. No group differences were observed for positive IOC domains, while BCSs with ASPs showed significantly poorer mean scores in the negative ones. BCSs with clinically defined movement restriction showed significantly poorer SF-36 and negative IOC mean scores than those with clinically defined lymphedema. The longitudinal sub-study of self-rated pain, restricted mobility and lymphedema showed significant changes over time only for negative IOC domains in the pain group. Self-rated restricted mobility and lymphedema were significantly associated with most SF-36 domains both in 2004 and 2007, while few were associated with pain. Self-rated pain and restricted mobility showed significant associations with negative IOC domains.
Not only lymphedema, but pain and restricted mobility in the arm/shoulder are significantly associated with poor QoL in BCSs at long-term. These problems should be diagnosed and treated in order to improve QoL.
本项针对乳腺癌幸存者（BCS）的横断面和纵向研究，考察了手臂/肩部问题（ASP）与生活质量（QoL）不同方面之间的关联，ASP 包括疼痛、活动受限和淋巴水肿。
对接受过乳房手术、腋窝淋巴结清扫术和放疗的 BCSs（n=255）进行了检查（术后平均 4.1 年），其中 187 名亚组患者于 2007 年再次接受检查。2004 年对 ASP 进行了临床评估，2004 年和 2007 年进行了自我报告（EORTC BR23）。使用简明健康调查问卷（SF-36）和癌症影响量表（IOC）进行自我报告 QoL 评估。
2004 年，患有 ASP 的 BCSs 在大多数 SF-36 领域的平均评分明显低于无 ASP 的 BCSs。在积极的 IOC 领域，两组之间没有差异，而在消极的 IOC 领域，患有 ASP 的 BCSs 的平均评分明显较低。在临床上定义为运动受限的 BCSs 的 SF-36 和消极 IOC 评分明显低于临床上定义为淋巴水肿的 BCSs。在自我报告的疼痛、活动受限和淋巴水肿的纵向亚研究中，只有疼痛组的消极 IOC 领域在随访期间显示出显著的变化。2004 年和 2007 年，自我报告的受限活动和淋巴水肿与大多数 SF-36 领域显著相关，而与疼痛相关的则较少。自我报告的疼痛和活动受限与消极的 IOC 领域有显著关联。
不仅淋巴水肿，手臂/肩部的疼痛和活动受限也与 BCSs 的长期 QoL 显著相关。为了提高 QoL，应诊断和治疗这些问题。
