Abstract
Background:
Understanding long-term arm symptoms in breast cancer survivors is critical given excellent survival in the modern era.
Methods:
This cross-sectional study included patients treated for stage 0–III breast cancer at our institution from 2002 to 2012. Patient-reported arm symptoms were collected from the EORTC QLQ-BR23 questionnaire. We used linear regression to evaluate adjusted associations between locoregional treatments and the continuous Arm Symptom (AS) score (0–100; higher score reflects more symptoms).
Results:
A total of 1126 patients expressed interest in participating and 882 (78.3%) completed the questionnaire. Mean time since surgery was 10.5 years. There was a broad distribution of locoregional treatments, including axillary lymph node dissection (ALND) in 37.1% of patients, mastectomy with reconstruction in 36.5% of patients, and post-mastectomy radiation in 38.2% of patients. Overall, 64.3% (95% confidence interval [CI] 61.1–67.4%) of patients reported no arm symptoms, 17.0% (95% CI 14.7–19.6%) had one mild symptom, 9.4% (95% CI 7.7–11.5%) had two or more mild symptoms, and 9.3% (95% CI 7.6–11.4%) reported one or more severe symptoms. Adjusted AS scores were significantly higher with ALND versus sentinel node biopsy (β 3.5, p = 0.01), and with autologous reconstruction versus all other breast/reconstructive surgery types (β 4.5–5.5, all p < 0.05). There was a significant interaction between axillary and breast/reconstructive surgery, with the greatest effect of ALND in those with mastectomy with implant (β 9.7) or autologous (β 5.7) reconstruction.
Conclusions:
One in three patients reported arm symptoms at a mean of 10 years from treatment for breast cancer, although rates of severe symptoms were low (<10%). Attention is warranted to the arm morbidity related to both axillary and breast surgery during treatment counseling and survivorship.
| Original language | English |
|---|---|
| Pages (from-to) | 1623-1633 |
| Number of pages | 11 |
| Journal | Annals of Surgical Oncology |
| Volume | 31 |
| Issue number | 3 |
| DOIs | |
| Publication status | Published - Mar 2024 |
Bibliographical note
Publisher Copyright:© Society of Surgical Oncology 2023. Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.
