Buchumschlag

Long-Term Patient-Reported Arm Symptoms in Breast Cancer Survivors

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Veröffentlicht in:Annals of Surgical Oncology vol. 31, no. 3 (Mar 2024), p. 1623
1. Verfasser: Laws, Alison
Weitere Verfasser: Lagendijk, Mirelle, Grossmith, Samantha, Hughes, Melissa, Lin, Nancy U., Mittendorf, Elizabeth A., Eliassen, A. Heather, King, Tari A., Dominici, Laura S.
Veröffentlicht:
Springer Nature B.V.
Schlagworte:
Patients
Mastectomy
Morbidity
Biopsy
Cancer therapies
Questionnaires
Reconstructive surgery
Breast cancer
Survival
Lymph nodes
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Abstract:BackgroundUnderstanding long-term arm symptoms in breast cancer survivors is critical given excellent survival in the modern era.MethodsThis cross-sectional study included patients treated for stage 0–III breast cancer at our institution from 2002 to 2012. Patient-reported arm symptoms were collected from the EORTC QLQ-BR23 questionnaire. We used linear regression to evaluate adjusted associations between locoregional treatments and the continuous Arm Symptom (AS) score (0–100; higher score reflects more symptoms).ResultsA total of 1126 patients expressed interest in participating and 882 (78.3%) completed the questionnaire. Mean time since surgery was 10.5 years. There was a broad distribution of locoregional treatments, including axillary lymph node dissection (ALND) in 37.1% of patients, mastectomy with reconstruction in 36.5% of patients, and post-mastectomy radiation in 38.2% of patients. Overall, 64.3% (95% confidence interval [CI] 61.1–67.4%) of patients reported no arm symptoms, 17.0% (95% CI 14.7–19.6%) had one mild symptom, 9.4% (95% CI 7.7–11.5%) had two or more mild symptoms, and 9.3% (95% CI 7.6–11.4%) reported one or more severe symptoms. Adjusted AS scores were significantly higher with ALND versus sentinel node biopsy (β 3.5, p&#xa0;=&#xa0;0.01), and with autologous reconstruction versus all other breast/reconstructive surgery types (β 4.5–5.5, all p&#xa0;<&#xa0;0.05). There was a significant interaction between axillary and breast/reconstructive surgery, with the greatest effect of ALND in those with mastectomy with implant (β 9.7) or autologous (β 5.7) reconstruction.ConclusionsOne in three patients reported arm symptoms at a mean of 10 years from treatment for breast cancer, although rates of severe symptoms were low (<10%). Attention is warranted to the arm morbidity related to both axillary and breast surgery during treatment counseling and survivorship.
ISSN:1068-9265
1534-4681
DOI:10.1245/s10434-023-14711-w
Quelle:Health & Medical Collection