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Physical activity level and age contribute to functioning problems in patients with breast cancer-related lymphedema: a multicentre cross-sectional study

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Abstract

Purpose

Breast cancer survivors face a high risk of developing breast cancer-related lymphedema (BCRL). Besides physical symptoms such as swelling, BCRL can have a psychosocial impact and lead to problems in daily functioning. Understanding contributing variables to problems in functioning yields possibilities to improve treatment modalities and consequently patients’ quality of life. Therefore, the aim of this study was to explore the association between patient-, lymphedema-, and cancer treatment-related variables with problems in functioning in patients with BCRL.

Methods

A cross-sectional study was performed in 185 patients with BCRL. Problems in daily functioning (dependent variable) were evaluated with the Lymph-ICF-UL questionnaire. Following independent variables were analysed by bi-variate and multivariable analyses, including a stepwise regression analysis: patient-related variables (age, BMI, physical activity level, education), lymphedema-related variables (excessive arm volume, duration of lymphedema, total pitting score, presence of hand edema, hardness of the tissue, lymphedema stage), and cancer treatment-related variables (type of surgery, surgery at the dominant side, radiotherapy, chemotherapy, hormone therapy, immunotherapy, TNM-classification).

Results

The Lymph-ICF-UL mean total score was 38% (± 21), representing a moderate amount of problems in general functioning. Multivariable regression analyses revealed that lower physical activity level and lower age are contributing factors to more problems in daily functioning. Stepwise regression analysis indicated that up to 8% of the variance in problems in functioning could be explained by physical activity level and age of patients with BCRL.

Conclusion

Especially patients with low physical activity level and younger patients experience more problems in functioning. For the determination of certain causal interactions, future longitudinal studies including other independent variables that might explain a higher amount of problems in functioning in this population, are warranted.

Trial registration

The study makes part of a double-blind, multi-center, randomized controlled trial (EFforT-BCRL trial), which is registered in clinicaltrials.gov (NCT02609724). CME reference S58689, EudraCT Number 2015-004822-33.

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Acknowledgments

All authors critically revised the manuscript for important intellectual content and approved the final manuscript.

Funding

This study is financed by the Agency for Innovation by Science and Technology, applied Biomedical Research (IWT 150178). In order to arrange such financing, a separate collaboration agreement has been signed by the KU Leuven and the beneficiaries.

Author information

Authors and Affiliations

  1. Department of Rehabilitation Sciences, KU Leuven, University of Leuven, Leuven, Belgium

    Tessa De Vrieze, An De Groef, Lore Dams, Elien Van der Gucht & Nele Devoogdt

  2. Department of Rehabilitation Sciences and Physiotherapy, University of Antwerp, MOVANT, Antwerp, Belgium

    Tessa De Vrieze, Nick Gebruers, Lore Dams & Elien Van der Gucht

  3. Research Group for Rehabilitation in Internal Disorders, Department of Rehabilitation Sciences, Catholic University of Leuven, O&N IV Herestraat 49, box 1510, 3000, Leuven, Belgium

    Tessa De Vrieze

  4. Research Group MOVANT, Department of Rehabilitation Sciences and Physiotherapy, University of Antwerp, Universiteitsplein 1, 2610, Wilrijk, Belgium

    Tessa De Vrieze

  5. Multidisciplinary Edema Clinic, University of Antwerp and Antwerp University Hospital, Antwerp, Belgium

    Nick Gebruers

  6. Multidisciplinary Breast Centre, UZ Leuven, University Hospitals Leuven, Leuven, Belgium

    Ines Nevelsteen

  7. Multidisciplinary Breast Clinic, Antwerp University Hospital, Antwerp, Belgium

    Wiebren A. A. Tjalma

  8. Department of Vascular Surgery and Department of Physical Medicine and Rehabilitation, Centre for Lymphedema, UZ Leuven, University Hospitals Leuven, Leuven, Belgium

    Sarah Thomis & Nele Devoogdt

Authors
  1. Tessa De Vrieze
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  2. Nick Gebruers
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  3. Ines Nevelsteen
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  4. Wiebren A. A. Tjalma
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  5. Sarah Thomis
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  6. An De Groef
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  7. Lore Dams
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  8. Elien Van der Gucht
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  9. Nele Devoogdt
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Corresponding author

Correspondence to Tessa De Vrieze.

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The authors have no conflicts of interest to declare. The authors have full control of all primary data and allow the journal to review the data if requested.

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Support statement: ADG is a post-doctoral research fellow of the FWO-Flanders.

Appendices

Appendix 1

Table 7 Predictive or contributing variables for problems in functioning in patients with BCRL
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Appendix 2

Table 8 Locations and measurement positioning for assessing the pitting score and the hardness of the tissue
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De Vrieze, T., Gebruers, N., Nevelsteen, I. et al. Physical activity level and age contribute to functioning problems in patients with breast cancer-related lymphedema: a multicentre cross-sectional study. Support Care Cancer 28, 5717–5731 (2020). https://doi.org/10.1007/s00520-020-05375-3

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  • DOI: https://doi.org/10.1007/s00520-020-05375-3

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