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Multidimensional Recovery Trajectories Throughout Breast Cancer Treatment and Survivorship: A Prospective
Laura Lorenzo-Gallego1,2, Nicola S Diciolla1,3,4, Fernando Ramos-Gómez5
1Physiotherapy Department, Physiotherapy in Women's Health Research Group, Faculty of Physiotherapy, University of Alcalá, 28805 Alcalá de Henares, Madrid, Spain.
Abstract:
Background: Breast cancer survivors frequently experience persistent sensory, psychosocial, and functional sequelae that may not be captured by pain measures alone. Understanding recovery trajectories throughout treatment and survivorship may help identify women at risk of long-term recovery-related difficulties. Objective: To investigate sensory, psychosocial, functional, and quality-of-life trajectories throughout breast cancer treatment. Methods: This prospective longitudinal study included women undergoing unilateral breast cancer surgery assessed at six time points before and after surgery, including before and after adjuvant treatments when applicable. Outcomes included sensory function, pain, upper-limb function, psychosocial variables, and quality of life. Results: Seventy-two women (57 ± 11 years) were included. Despite stable pain intensity and self-reported sensitization symptoms, fear of movement increased (TSK-11: MD [95%CI] = +9[0;22]), quality of life deteriorated (FACT-B: 3-12 month MD [95%CI] = -10[-19;-1]), and upper-limb function initially worsened before partially recovering. Objective sensory alterations suggested dynamic changes in somatosensory processing but were not consistently accompanied by greater pain intensity or self-reported sensitization symptoms. Conclusions: Recovery after breast cancer treatment is multidimensional and cannot be adequately reflected by pain intensity alone. Multidimensional assessment may help identify women at risk of persistent recovery-related difficulties and support personalized survivorship care.
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