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患者报告的上身症状能否预测乳腺癌相关淋巴水肿:一项基于人群的纵向乳腺癌队列研究结果

Do Patient-Reported Upper-Body Symptoms Predict Breast Cancer-Related Lymphoedema: Results from a Population-Based, Longitudinal Breast Cancer Cohort Study.

作者信息

Hayes Sandra C, Dunn Matthew, Plinsinga Melanie L, Reul-Hirche Hildegard, Ren Yumeng, Laakso E-Liisa, Troester Melissa A

机构信息

Menzies Health Institute Queensland, Griffith University, Brisbane 4111, Australia.

School of Health Sciences and Social Work, Griffith University, Brisbane 4111, Australia.

出版信息

Cancers (Basel). 2022 Dec 5;14(23):5998. doi: 10.3390/cancers14235998.

Abstract

The objectives of this work were to (i) describe upper-body symptoms post-breast cancer; (ii) explore the relationship between symptoms and upper-body function, breast cancer-related lymphoedema (BCRL), physical activity levels, and quality of life; and (iii) determine whether the presence of upper-body symptoms predicts BCRL. Nine symptoms, upper-body function, lymphoedema, physical activity, and quality of life were assessed in women with invasive breast cancer at baseline (2- to 9-months post-diagnosis; n = 2442), and at 2- and 7-years post-diagnosis. Mann−Whitney tests, unpaired t-tests, and chi-squared analyses were used to assess cross-sectional relationships, while regression analyses were used to assess the predictive relationships between symptoms at baseline, and BCRL at 2- and 7-years post-diagnosis. Symptoms are common post-breast cancer and persist at 2- and 7-years post-diagnosis. Approximately two in three women, and one in three women, reported >2 symptoms of at least mild severity, and of at least moderate severity, respectively. The presence of symptoms is associated with poorer upper-body function, and lower physical activity levels and quality of life. One or more symptoms of at least moderate severity increases the odds of developing BCRL by 2- and 7-years post-diagnosis (p < 0.05). Consequently, improved monitoring and management of symptoms following breast cancer have the potential to improve health outcomes.

摘要

这项工作的目标是

(i)描述乳腺癌后的上身症状;(ii)探究症状与上身功能、乳腺癌相关淋巴水肿(BCRL)、身体活动水平及生活质量之间的关系;(iii)确定上身症状的存在是否可预测BCRL。在2442例浸润性乳腺癌女性患者诊断后2至9个月(基线期)、诊断后2年及7年时,评估了九种症状、上身功能、淋巴水肿、身体活动及生活质量。采用曼-惠特尼检验、非配对t检验和卡方分析来评估横断面关系,同时采用回归分析来评估基线期症状与诊断后2年及7年时BCRL之间的预测关系。乳腺癌后症状很常见,且在诊断后2年及7年时持续存在。分别约有三分之二的女性和三分之一的女性报告至少有2种至少为轻度严重程度的症状以及至少为中度严重程度的症状。症状的存在与较差的上身功能、较低的身体活动水平及生活质量相关。至少有1种中度严重程度或以上的症状会使诊断后2年及7年时发生BCRL的几率增加(p<0.05)。因此,改善乳腺癌后症状的监测与管理有可能改善健康结局。

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