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Predicting recreational difficulties and decreased leisure activities in women 6–12 months post breast cancer surgery

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Abstract

Introduction

A Canadian research team is conducting a multi-centered, non-interventional national study with the objective of charting the course of arm morbidity after breast cancer surgery. This paper examined the relationship between arm morbidity and leisure and recreational activities of affected women.

Methods

Five hundred and forty seven women with stage I-III breast cancer were recruited in four centers across Canada: Surrey (BC); Winnipeg (MB), Montreal (QB) and Fredericton (NB). Participants were enrolled in the study 6–12 months post surgery. Physical examination was used to assess arm and shoulder functioning and questionnaires were used to assess disability, pain, and participation in recreational and leisure activities.

Results

At the first clinical assessment (T1), the mean number of months post breast cancer surgery was 8.4. At T1 49% of women reported difficulty with recreational activities that involved “some force or impact” and 29% experienced negative changes to their involvement in leisure activities. A hierarchical multiple regression analysis found that several arm morbidity variables were significant predictors of difficulty with participation in recreational activities. A second hierarchical regression found also that arm morbidity factors were significant predictors of negative changes in leisure activities. Follow-up analyses found that arm morbidity, was most closely related to difficulty with recreational activities requiring free movement of the arm and using force.

Conclusion

Many women treated for breast cancer experience arm morbidity. Arm morbidity is related to difficulties with recreational activities and negative changes in leisure activity participation.

Implications

Breast cancer survivors should engage in recreational and leisure activities that are compatible with reduced range of motion and pain, and avoid those that exacerbate their arm morbidity.

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Notes

  1. Of the sample, 16% were diagnosed outside the 6 and 12 months post surgery range: 60 (10%) women <6 months and 35 (6%) >12 months. Statistics are based on all 574 women.

References

  1. International Society of Lymphology. The diagnosis and treatment of peripheral lymphedema. Consensus document of the International Society of Lymphology. Lymphology. 2003;36(2), 84–91.

    Google Scholar 

  2. American Cancer Society. (2008). “Understanding Lymphedema.” from http://www.cancer.org/docroot/MIT/content/MIT_7_2x_Understanding_Lymphedema.asp.

  3. Andrykowski MA, Beacham AO, et al. “Prospective, longitudinal study of leisure-time exercise in women with early-stage breast cancer.” Cancer Epidemiol Biomarkers Prev. 2007;16(3):430–8.

    Article  PubMed  Google Scholar 

  4. Beaton DE, Katz JN, Fossel AH, Wright JG, Tarasuk V, Bombardier C. “Measuring the whole or the parts? Validity, reliability, and responsiveness of the disabilities of the arm, shoulder and hand outcome measure in different regions of the upper extremity.” J Hand Ther. 2001;14(2):128–46.

    PubMed  CAS  Google Scholar 

  5. Brennan MJ, DePompolo RW, Garden FH. “Focused review: postmastectomy lymphedema.” Arch Phys Med Rehabil. 1996;77(3 Suppl):S74–80.

    Article  PubMed  CAS  Google Scholar 

  6. Myers Lowe R. Lymphedema. Cancerpage.com. Accessed April 5, 2008. http://www.cancerpage.com/center/sideeffects/Lymphedema.asp

  7. Coster S, Poole K, Fallowfield LJ. “The validation of a quality of life scale to assess the impact of arm morbidity in breast cancer patients post-operatively.” Breast Cancer Res Treat. 2001;68(3):273–82.

    Article  PubMed  CAS  Google Scholar 

  8. Dorval M, Maunsell E, Deschenes L, Brisson J, Masse B. “Long-term quality of life after breast cancer: comparison of 8-year survivors with population controls.” J Clin Oncol. 1998;16(2):487–94.

    PubMed  CAS  Google Scholar 

  9. Engel J, Kerr J, Schlesinger-Raab A, Sauer H, Hölzel D. “Axilla surgery severely affects quality of life: results of a 5-year prospective study in breast cancer patients.” Breast Cancer Res Treat. 2003;79(1):47–57.

    Article  PubMed  Google Scholar 

  10. Harris SR, Niesen-Vertommen SL. “Challenging the myth of exercise-induced lymphedema following breast cancer: a series of case reports.” J Surg Oncol. 2000;74(2):95–8. discussion 98–9.

    Article  PubMed  CAS  Google Scholar 

  11. Karges JR, Mark BE, Stikeleather SJ, Worrell TW. “Concurrent validity of upper-extremity volume estimates: comparison of calculated volume derived from girth measurements and water displacement volume.” Phys Ther. 2003;83(2):134–45.

    PubMed  Google Scholar 

  12. Karki A, Simonen R, Mälkiä E, Selfe J. “Impairments, activity limitations and participation restrictions 6 and 12 months after breast cancer operation.” J Rehabil Med. 2005;37(3):180–8.

    PubMed  Google Scholar 

  13. Keays KS, Harris SR, Lucyshyn JM, MacIntyre DL. “Effects of pilates exercises on shoulder range of motion, pain, mood, and upper-extremity function in women living with breast cancer: a pilot study.” Phys Ther. 2008;88(4):494–510.

    PubMed  Google Scholar 

  14. Kwan W, Jackson J, Weir LM, Dingee C, McGregor G, Olivotto IA. “Chronic arm morbidity after curative breast cancer treatment: prevalence and impact on quality of life.” J Clin Oncol. 2002;20(20):4242–8.

    Article  PubMed  Google Scholar 

  15. Mackenzie D. “Abreast in a boat-race against breast cancer.” Can Med Assoc J. 1998;159:376–8.

    Google Scholar 

  16. Miedema B, Hamilton R, Easley MA. “From “invincibility” to “normalcy”: coping strategies of young adults during the cancer journey.” Palliative & Supportive Care. 2007;5(1):41–9.

    Article  Google Scholar 

  17. Pain SJ, Purushotham AD. “Lymphoedema following surgery for breast cancer.” Br J Surg. 2000;87(9):1128–41.

    Article  PubMed  CAS  Google Scholar 

  18. Rietman JS, Dijkstra PU, Hoekstra HJ, Eisma WH, Szabo BG, Groothoff JW, et al. “Late morbidity after treatment of breast cancer in relation to daily activities and quality of life: a systematic review.” Eur J Surg Oncol. 2003;29(3):229–38.

    Article  PubMed  CAS  Google Scholar 

  19. Rockson SG. “Precipitating factors in lymphedema: myths and realities.” Cancer. 1998;83(12 Suppl American):2814–6.

    Article  PubMed  CAS  Google Scholar 

  20. Shannon C, Shaw SM. “If the dishes don’t get done today, they’ll get done tomorrow”: a breast cancer experience as a catalyst for changes to women’s leisure.” J Leis Res. 2005;37(2):195–215.

    Google Scholar 

  21. Shimozuma K, Ganz PA, Petersen L, Hirji K. “Quality of life in the first year after breast cancer surgery: rehabilitation needs and patterns of recovery.” Breast Cancer Res Treat. 1999;56(1):45–57.

    Article  PubMed  CAS  Google Scholar 

  22. Smith WC, Bourne D, Squair J, O. Phillips D, Alastair Chambers W. “A retrospective cohort study of post mastectomy pain syndrome.” Pain. 1999;83(1):91–5.

    Article  PubMed  CAS  Google Scholar 

  23. Thomas-MacLean R, Miedema B, Tatemichi SR. “Breast cancer-related lymphedema: women’s experiences with an underestimated condition.” Can Fam Physician. 2005;51:246–7.

    PubMed  Google Scholar 

  24. Thomas-MacLean RL, Hack T, Kwan W, Towers A, Miedema B, Tilley A. “Arm morbidity and disability after breast cancer: new directions for care.” Oncol Nurs Forum. 2008;35(1):65–71.

    Article  PubMed  Google Scholar 

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Acknowledgement

Canadian Institutes of Health Research (CIHR) MOP 68883

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Authors and Affiliations

  1. Dalhousie University Family Medicine Teaching Unit, Dr. Everett Chalmers Regional Hospital, 700 Priestman Street, Fredericton, NB, Canada

    Baukje Miedema, Ryan Hamilton & Sue Tatemichi

  2. University of Saskatchewan, Saskatoon, SK, Canada

    Roanne Thomas-MacLean

  3. Faculty of Medicine, McGill University, Montreal, QC, Canada

    Anna Towers

  4. Faculty of Nursing, University of Manitoba, Winnipeg, MB, Canada

    Thomas F. Hack

  5. Atlantic Health Sciences Corporation, Saint John, NB, Canada

    Andrea Tilley

  6. British Columbia Cancer Agency, Surrey, BC, Canada

    Winkle Kwan

Authors
  1. Baukje Miedema
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  2. Ryan Hamilton
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  3. Sue Tatemichi
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  4. Roanne Thomas-MacLean
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  5. Anna Towers
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  6. Thomas F. Hack
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  7. Andrea Tilley
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  8. Winkle Kwan
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Correspondence to Baukje Miedema.

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Miedema, B., Hamilton, R., Tatemichi, S. et al. Predicting recreational difficulties and decreased leisure activities in women 6–12 months post breast cancer surgery. J Cancer Surviv 2, 262–268 (2008). https://doi.org/10.1007/s11764-008-0068-8

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  • DOI: https://doi.org/10.1007/s11764-008-0068-8

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