Evaluation of upper extremity performance in women with and without breast cancer-related lymphedema

Breast cancer-related lymphedema may negatively affect upper extremity function; however, objective evidence regarding task-oriented upper extremity performance and hand reaction time in this population remains limited.

To compare upper extremity performance and hand reaction time in women with and without breast cancer-related lymphedema after breast cancer treatment.

Cross-sectional study.

Fifty women after breast cancer treatment were included: 25 with breast cancer-related lymphedema and 25 without lymphedema. Limb volume was calculated using the frustum formula from circumferential measurements taken at 5-cm intervals. Upper extremity performance was assessed using the Timed Functional Arm and Shoulder Test (TFAST), and hand reaction time was assessed using the Nelson Hand Reaction Test (NHRT).

Age, body mass index (BMI), pain intensity, and time since surgery were comparable between groups. Affected-side arm volume was higher in the breast cancer-related lymphedema group than in the non-lymphedema group (2095.5 ± 425.7 cm³ vs 1695.9 ± 365.5 cm³; mean difference: 399.6 cm³; p < 0.001). TFAST scores were lower in women with breast cancer-related lymphedema on the affected/dominant side (median: 41 vs 53; r = 0.69; p < 0.001) and on the unaffected/non-dominant side (median: 39 vs 57; r = 0.67; p < 0.001). NHRT reaction time in the affected hand was longer in the breast cancer-related lymphedema group (median: 0.259 seconds vs 0.234 seconds; r = 0.66; p < 0.001). Limb volume was negatively correlated with affected-side TFAST scores in women with breast cancer-related lymphedema (r = -0.58, p = 0.002), but not with NHRT scores (r = 0.15, p = 0.227).

Breast cancer-related lymphedema is associated with clinically meaningful impairments in task-oriented upper extremity performance and longer affected-hand reaction time. Performance-based assessment may help identify functional impairments associated with breast cancer-related lymphedema and guide individualized hand and upper extremity rehabilitation for women after breast cancer treatment.