Long-term Implications of Breast Cancer on Upper Extremity Functioning, Participation and Perceived Quality of Life Over its Aesthetic Appearance

Objective: The objectives of the study were: (a) to evaluate the long-term implications of breast cancer on upper extremity function, participation and perceived quality of life (QoL) among Israeli women; (b) to examine the use of rehabilitation services during the recovery process).

Methods: An online survey was distributed via electronic media. The Quick Disabilities of Arm Shoulder and Hand (Quick DASH) questionnaire was used to assess upper extremity disability, QoL was assessed by the Functional Assessment of Cancer Therapy-Breast (FACT-B) questionnaire and function and disability by the World Health Organization Disability Assessment Schedule- WHODAS 2.

Results: 139 women participated in the study (Mean age = 49.6 SD = 9.46), 1 month to 10 years (mean = 36.6, SD = 26.9) post-diagnosis. Seventy percent of the women reported developing upper extremity disability during or after the medical treatment, and 50% reported that this disability continued after the treatment ended. The average Quick DASH score was 32.4 (SD = 24.69), higher than the norms of 10-15 (SD=3). A high positive significant correlation was found between upper extremity disability and general function (r=.853; p=.001) and a moderate to high negative correlation was observed with the QoL (r=.-575; p=.001), demonstrating that upper extremity disability resulted in lower perceived QoL. Only 30% of the women reported receiving a referral to rehabilitation.

Conclusion: The present survey demonstrated that women with breast cancer reported disability in their upper extremity that was associated with general disability and decreased perceived QoL. However, less than a third of the women were offered rehabilitation services. It appears that there is a need to investigate the nature of the upper extremity function and disability of women with breast cancer further; to raise physicians and rehabilitation professions awareness to the problem and provide services that can improve function; and to develop appropriate rehabilitation for this population.