The relationship between impaired upper-body function, quality of life and breast cancer-related lymphoedema: results from a prospective, population-based cohort study

To describe upper-body function in women after breast cancer treatment; and to explore the relationship between upper-body function, quality of life and breast cancer- related lymphoedema up to 7-years post-diagnosis.

This study uses data collected in a prospective, longitudinal, population-based, breast cancer cohort study. The Disability of Arm, Shoulder and Hand questionnaire (short version -QuickDASH), the Functional Assessment of Cancer Therapy-Breast questionnaire (FACT-B) and self-report of a clinical diagnosis were used to assess upper-body function, quality of life and breast cancer-related lymphoedema, respectively, in 2,876 women with invasive breast cancer at three time points: baseline (up to 9 months post-diagnosis), and at 2- and 7-years post-diagnosis. Unadjusted cross-sectional relationships between outcomes of interest were tested at each time point. Unadjusted and adjusted regression analyses were used to explore the potential predictive relationship between upper-body function and lymphoedema.

Upper-body impairment was common up to 7-years post-diagnosis with > 60% of women reporting at least mild impairment and 23.8-25.6% reporting moderate to very severe impairment. Impaired upper-body function at baseline assessment was associated with poorer overall quality of life (mean (standard deviation) FACT-B for no versus mild impairment: 77.5 (11.8) versus 70.9 (12.1), p < 0.05) and increased odds of breast cancer-related lymphoedema at 2 and 7 years follow-up (moderate to severe upper-body function impairment at 2- and 7- years post-diagnosis: Odds Ratio (95% Confidence interval) 2.49 (1.57, 3.93) and 2.54 (1.51, 4.26), respectively).

Future research evaluating whether prospective monitoring of upper-body function and interventions that can address impairment can reduce the risk of breast cancer-related lymphoedema are warranted.