Shoulder Complex Motion and Coordination Impairments, and the Associated Clinical Factors in Women with a History of Breast Cancer Treatment

Upper limb function: Comparison of postmenopause women with and without a history of early breast cancer.

Journal of Clinical Oncology ◽

10.1200/jco.2013.31.15_suppl.e20578 ◽

2013 ◽

Vol 31 (15_suppl) ◽

pp. e20578-e20578

Author(s):

Nasim Foroughi ◽

Mi-Joung Lee ◽

Sharon Kilbreath

Keyword(s):

Breast Cancer ◽

Cancer Treatment ◽

Early Breast Cancer ◽

Upper Limb ◽

Breast Cancer Treatment ◽

Community Dwelling ◽

Control Group ◽

Menopausal Women ◽

History Of ◽

Post Menopausal

e20578 Background: Long term upper limb impairments following early breast cancer treatment are commonly reported in women years following surgery. However, the extent to which the symptoms are related to menopause and ageing, rather than cancer, has not been explored. This study aimed to compare upper limb strength, shoulder forward flexion range of motion (FF RoM), and presence of impairments in post menopausal women with and without a history of breast cancer. Methods: Community–dwelling age and body mass index (BMI)-matched post menopausal women with (n=40) and without a history of early breast cancer treatment (n=40) participated. Women with other types of cancer, metastatic cancer, and significant neurological or musculoskeletal history unrelated to breast cancer were excluded. Peak shoulder muscle strength was assessed using pneumatic resistance machines and FF RoM with a digital inclinometer. Participants completed the Disability of arm, shoulder and hand (DASH) questionnaire. Between groups comparison were made using analysis of co-variance with age and BMI as confounding variables. Results: Upper limb strength (206.22±45.0 vs. 225.36±86.9 Nm/kg, p=0.091) and FF RoM (166.75±7.9◦ vs. 170.14±6.9◦, p=0.259) were not significantly different between the study and the control group. There were no significant differences between the groups on any of the DASH sub scores (pain: 9.18±8.1 vs. 8.62±8.2, P=0.770). Conclusions: Upper limb impairments are often presumed to be a consequence of surgical procedures in women with breast cancer. However, some of the symptoms women perceive years following surgery may be related to the changes due to aging or menopause rather than cancer treatment.

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Racial/ethnic differences in treatment delay in a multiethnic sample of women with breast cancer

Journal of Clinical Oncology ◽

10.1200/jco.2009.27.15_suppl.6503 ◽

2009 ◽

Vol 27 (15_suppl) ◽

pp. 6503-6503

Author(s):

M. Mujahid ◽

S. Hawley ◽

N. K. Janz ◽

A. Hamilton ◽

J. Graff ◽

...

Keyword(s):

Breast Cancer ◽

Cancer Treatment ◽

Ethnic Differences ◽

Surgical Procedure ◽

White Women ◽

Treatment Delay ◽

Population Based ◽

Breast Cancer Treatment ◽

Clinical Factors ◽

Racial Ethnic

6503 Background: Factors contributing to racial/ethnic variation in breast cancer treatment delay remain understudied, especially in multi-ethnic population-based samples. Methods: 3,252 women with non-metastatic breast cancer diagnosed between 6/05–2/07 and reported to the Los Angeles County and Detroit, Surveillance Epidemiologic and End Results (SEER) registries were surveyed after initial treatment (mean time from diagnosis = 8.9 months). Latina and African American (AA) women were over- sampled (n=2260, eligible response rate 72.1%). Treatment delay was defined as the patient's report of the duration between when breast cancer was first diagnosed and first surgical procedure (< 1month, 1–3months, ≥4 months) . Multinomial logistic regression models were used to estimate the relative odds of treatment delay by race/ethnicity before and after adjustment for sociodemographics (age, education, income, marital status), clinical factors (number of co-morbidities, health status at diagnosis), and access barriers (difficulty: finding doctors to treat cancer, scheduling surgical procedure, getting to doctor's office). Results: Of the 2195 women who had a surgical procedure, 6.9 % experienced treatment delay of ≥4 months (10.4% Latina, 9.3% AA, 5.5% white women). Latina and AA women were more likely to experience longer treatment delay than white women [OR for ≥4 months/1–3 months vs. < 1 month: 2.18/1.77 for Latinas; 1.78/1.50 for AA (p<.001)] (Table). Racial/ethnic differences persisted after adjustment for sociodemographic, clinical factors, and access barriers [OR for ≥4 months/1–3 months vs. < 1 month: 1.31/1.79 for Latinas; 1.64/1.55 for AA, (p<.001)] (Table), although Latina vs. white differences were no longer statistically significant. Conclusions: Our results confirm that racial/ethnic minorities are vulnerable to delay in receipt of breast cancer treatment in a large population based sample of breast cancer patients. Further work is needed to evaluate the underlying causes of this delay. [Table: see text] No significant financial relationships to disclose.

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