Department of Rehabilitation Medicine, Shanghai Jing'an District Central Hospital, Shanghai, China.
Sci Rep. 2023 Oct 27;13(1):18458. doi: 10.1038/s41598-023-45731-x.
The incidence of breast cancer in China was 19.2% in 2018, with a five-year survival rate of up to 80%. The impairments that may result from breast cancer treatment, such as lymphedema, pain, and symptoms related to nerve damage, could have long-term side effects. Its prevalence and symptom profile have been commonly reported in various countries, but such data are rarely available for China. Physical function was assessed in 138 breast cancer survivors (BCSs) in the study. The prevalence of lymphedema (65.9%) was higher than that of pain (31.2%), shoulder range of motion (ROM) restriction (20.3%), grip strength restriction (GSR) (21.7%) and paresthesia (11.6%). These impairments mainly appeared within 28 months after breast cancer diagnosis, but could happen in 10 years. Carcinoma in situ and radiotherapy (RT) were related to the occurrence of lymphedema (respectively B = -1.8, p = 0.003; B = 1.3, p = 0.001). RT and delayed rehabilitation time (DRT) may increase the severity of lymphedema (respectively p = 0.003, p = 0.010). Breast conserving surgery (B = -2.1, p = 0.002) and the occurrence of AWS (B = 3.1, p = 0.006) were related to the occurrence of pain. The occurrence of brachial plexus injury (BPI) (B = 3.1, p < 0.001) and pain (B = 1.9, p = 0.002) improved the occurrence of shoulder ROM restriction. The occurrence of BPI (B = 3.6, p < 0.001) improved the occurrence of GSR. The occurrence of pain (B = 2.1, p = 0.001) improved the occurrence of paresthesia. These findings prompt us to further investigate the actual rehabilitation needs of survivors and the specific barriers to rehabilitation in the following research.
2018 年中国乳腺癌发病率为 19.2%,五年生存率高达 80%。乳腺癌治疗可能导致的淋巴水肿、疼痛和与神经损伤相关的症状等损伤,可能会产生长期的副作用。这些在不同国家都有常见报道,但中国很少有此类数据。在该研究中评估了 138 名乳腺癌幸存者(BCS)的身体功能。淋巴水肿(65.9%)的患病率高于疼痛(31.2%)、肩部活动范围(ROM)受限(20.3%)、握力受限(21.7%)和感觉异常(11.6%)。这些损伤主要出现在乳腺癌诊断后 28 个月内,但也可能在 10 年内发生。原位癌和放疗(RT)与淋巴水肿的发生有关(分别为 B=-1.8,p=0.003;B=1.3,p=0.001)。RT 和延迟康复时间(DRT)可能会增加淋巴水肿的严重程度(分别为 p=0.003,p=0.010)。保乳手术(B=-2.1,p=0.002)和 AWS 的发生(B=3.1,p=0.006)与疼痛的发生有关。臂丛神经损伤(BPI)(B=3.1,p<0.001)和疼痛(B=1.9,p=0.002)的发生改善了肩部 ROM 受限的发生。BPI 的发生(B=3.6,p<0.001)改善了握力受限的发生。疼痛的发生(B=2.1,p=0.001)改善了感觉异常的发生。这些发现促使我们在以下研究中进一步调查幸存者的实际康复需求和康复的具体障碍。