Open AccessRisk of Decline in Upper‐Body Function and Symptoms Among Older Breast Cancer Patients
Author(s) -
Westrup Jennifer L.,
Lash Timothy L.,
Thwin Soe Soe,
Silliman Rebecca A.
Publication year - 2006
Publication title -
journal of general internal medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.746
H-Index - 180
eISSN - 1525-1497
pISSN - 0884-8734
DOI - 10.1111/j.1525-1497.2006.00384.x
Subject(s) - medicine , breast cancer , body mass index , prospective cohort study , cancer , odds ratio , cohort study , cohort , confidence interval , surgery
BACKGROUND: Decline in upper‐body function and development of upper‐body symptoms are adverse effects of breast cancer therapy and may affect functional independence, particularly among older survivors. The long‐term risks and predictors are poorly understood. OBJECTIVE: To characterize the risk of decline in upper‐body function and development of symptoms over 4 years of follow‐up. DESIGN: We used a prospective cohort design. PARTICIPANTS: Six hundred and forty‐four early stage breast cancer patients 65 years old or older at surgery enrolled in Rhode Island, North Carolina, Minnesota, and Los Angeles between 1996 and 1999. MEASUREMENTS: Upper‐body function and symptoms were self‐reported at baseline, 6, 15 months, and annually thereafter to 51 months after surgery. RESULTS: One half of the participants had a decline in upper‐body function and one‐quarter developed upper‐body symptoms. Breast cancer patients were 5‐fold more likely to have a decline in upper‐body function over 4 years of follow‐up than a similar cohort without breast cancer. Better baseline mental health protected against a decline in upper‐body function (odds ratio [OR]=0.93, 95% confidence interval [CI] 0.88 to 0.97 for 8‐point higher mental health index). Baseline obesity (OR for body mass index [BMI] ≥30 kg/m 2 vs <30 kg/m 2 =2.5, CI=1.6 to 4.0) and axillary node dissection (OR for axillary dissection vs not=3.9, CI=1.1 to 14) predicted the development of upper‐body symptoms. CONCLUSIONS: Primary care physicians should address upper‐body function and symptoms with older breast cancer patients, and inform them that these complications of breast cancer treatment are common.