The risk factors and prevalence of upper extremity impairments and an analysis of effects of lymphoedema and other impairments on the quality of life of breast cancer patients

Kibar S., Dalyan Yan Aras M. & €unsal Delialioglu. (2017) European Journal of Cancer Care 26.

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The risk factors and prevalence of upper extremity impairments and an analysis of effects of lymphoedema and other impairments on the quality of life of breast cancer patients

Kibar S., Dalyan Yan Aras M. & €unsal Delialioglu. (2017) European Journal of Cancer Care 26.

This study aimed to determine the prevalence and identify the risk factors associated with upper extremity impairments (UEIs) in breast cancer patients and to investigate the degree to which these impairments and other characteristics influence quality of life (QoL). A total of 201 women over the age of 18 who underwent breast cancer treatment at least 6 months were included in this cross-sectional study. All of the patients were evaluated for the presence of lymphoedema and any UEIs. UEIs divided into five subgroups: pain, restriction of shoulder range of motion (ROM), numbness and heaviness, loss of strength, and sensory deficit. QoL of the patients was evaluated by SF-36. The prevalence of the upper extremity impairments was as follows: pain 31.8%, restriction of shoulder ROM 23.9%, numbness and heaviness 35.3%, loss of strength 8.5%, and sensory deficit 18.4%. Furthermore, lymphoedema was seen in 41.3% of patients. The multivariate model showed that lymphoedema is the only statistically significant risk factor that affects the development of UEIs (P = 0.001). However, it also revealed that lymphoedema (P = 0.001) and increased age negatively affect QoL, whereas prolongation of the follow-up period has a favourable impact (P = 0.016). Therefore, lymphoedema diminishes QoL via an increased number of UEIs.

Main findings

  • It is unclear when the objective measurements were exactly taken post treatment.
  • The study population’s characteristics are consistent with low socioeconomic status. In this study, development of at least one upper extremity impairment and lymphoedema were determined in the patients with breast cancer who underwent level III ALND, 53.1% and 41.3% respectively.
  • All patients underwent level III ALND, and a great majority had modified radical mastectomy. The prevalence of restricted ROM was 23.9%.
  • 5% of patients had loss of strength.
  • The risk of intercostobrachial and medial cutaneous nerve damage increases with ALND, causing sensorial impairment. Impairment was seen in 18% of the patients.
  • 35% of the patients in the study complained of numbness and heaviness.
  • In the present study, the prolonged follow-up period was found to have a favourable impact on quality of life.
  • There are some limitations for this study. The study population’s characteristics are consistent with low socioeconomic status. Most of the patients in this study were illiterate or had primary school education, unemployed and overweight or obese.