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- Title
Risk of decline in upper-body function and symptoms among older breast cancer patients.
- Authors
Westrup, Jennifer L.; Lash, Timothy L.; Thwin, Soe Soe; SilliMan, Rebecca A.
- Abstract
<bold>Background: </bold>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.<bold>Objective: </bold>To characterize the risk of decline in upper-body function and development of symptoms over 4 years of follow-up.<bold>Design: </bold>We used a prospective cohort design.<bold>Participants: </bold>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.<bold>Measurements: </bold>Upper-body function and symptoms were self-reported at baseline, 6, 15 months, and annually thereafter to 51 months after surgery.<bold>Results: </bold>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] > or =30 kg/m2 vs <30 kg/m2=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.<bold>Conclusions: </bold>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.
- Subjects
BREAST cancer surgery; CANCER patients; CANCER treatment; DISEASES in older people; SURGICAL complications; OBESITY
- Publication
JGIM: Journal of General Internal Medicine, 2006, Vol 21, Issue 4, p327
- ISSN
0884-8734
- Publication type
journal article
- DOI
10.1111/j.1525-1497.2006.00384.x