Advertisement

Supportive Care in Cancer

, Volume 19, Issue 5, pp 599–604 | Cite as

Can ICF model for patients with breast-cancer-related lymphedema predict quality of life?

  • Jau-Yih Tsauo
  • Hsiu-Chuan Hung
  • Han-Ju Tsai
  • Chiun-Sheng HuangEmail author
Original Article

Abstract

Goal of work

The aim of the study was to investigate if the International Classification of Functioning, Disability and Health (ICF) model with clinical data from patients with breast-cancer-related lymphedema can predict their health-related quality of life (HRQL).

Materials and methods

Sixty-one patients with breast-cancer-related lymphedema were recruited. Data were collected from records, including age, type(s) of surgery, number of dissected lymph nodes and history of radiotherapy and/or chemotherapy, duration of lymphedema, and duration between surgery and enrollment. Excessive arm volume, average arm symptom, function of upper extremity (U/E), and HRQL were assessed four times during and after patients’ treatment of lymphedema.

Results

The ICF model accounted for 20.5% to 55.6% variance in each domain of HRQL. Activity and participation reflected by U/E function were the most important factor, significantly predicting every domain of HRQL. Among measured impairments, average arm symptom was found to be most correlated with U/E function (r = 0.590, P < 0.05).

Conclusion

The ICF model consisting of clinical measures for patients with breast-cancer-related lymphedema can predict their HRQL. Activity and participation were the most important component. Arm symptoms rather than arm volume significantly correlated with U/E function. This might suggest that reducing arm symptoms is relatively more important while treating patients with breast-cancer-related lymphedema.

Keywords

Breast cancer Lymphedema Impairment Disability Quality of life 

Notes

Acknowledgments

The authors thank the participants and the National Science Council of the Republic of China for financial support under grant nos. NSC93-2314-B-002-118 and NSC94-2314-B-002-074, which made this study possible.

References

  1. 1.
    Andersen L, Hojris I, Erlandsen M, Andersen J (2000) Treatment of breast-cancer-related lymphedema with or without manual lymphatic drainage—a randomized study. Acta Oncol 39:399–405PubMedCrossRefGoogle Scholar
  2. 2.
    Bunce IH, Miroli BR, Hennessy JM, Ward LC, Jones LC (1994) Postmasectomy lymphoedema treatment and measurement. Med J Aust 161:125–128PubMedGoogle Scholar
  3. 3.
    Caban ME (2002) Trends in the evaluation of lymphedema. Lymphology 35:28–38PubMedGoogle Scholar
  4. 4.
    Carati CJ, Anderson SN, Gannon BJ, Piller NB (2003) Treatment of postmasecotmy lymphoedema with low level laser therapy. Cancer 98:1114–1122PubMedCrossRefGoogle Scholar
  5. 5.
    Chen YW, Tsai HJ, Hung HC, Tsauo JY (2008) Reliability study of measurements for lymphedema in breast cancer patients. Am J Phys Med Rehabil 87:33–38PubMedCrossRefGoogle Scholar
  6. 6.
    Clodius L, Deak L, Piller NB (1976) A new instrument for the evaluation of tissue tonicity in lymphoedema. Lymphology 9:1–5PubMedGoogle Scholar
  7. 7.
    Cohen SR, Payne DK, Tunkel RS (2001) Lymphedema. Cancer 92:980–987PubMedCrossRefGoogle Scholar
  8. 8.
    Engel J, Kerr J, Schlesinger-Raab A, Sauer H, Holzel D (2003) Axilla surgery severely affects quality of life: results of a 5-year prospective study in breast cancer patients. [Erratum appears in Breast Cancer Res Treat 2003 Jul;80(2):233]. Breast Cancer Res Treat 79:47–57PubMedCrossRefGoogle Scholar
  9. 9.
    Gosselink R, Rouffaer L, Vanhelden P, Piot W, Troosters T, Christiaens MR (2003) Recover of upper limb function after axillary dissection. J Surg Oncol 83:204–211PubMedCrossRefGoogle Scholar
  10. 10.
    Hack TF, Cohen L, Katz J, Robson LS, Goss P (1999) Physical and psychological morbidity after axillary lymph node dissection for breast cancer. J Clin Oncol 17:143–149PubMedGoogle Scholar
  11. 11.
    Hladiuk M, Huchcroft S, Temple W, Schnurr BE (1992) Arm function after axillary dissection for breast cancer: a pilot study to provide parameter estimates. J Surg Oncol 50:47–52PubMedCrossRefGoogle Scholar
  12. 12.
    Jette AM (2006) Toward a common language for function, disability, and health. Phys Ther 86:726–734PubMedCrossRefGoogle Scholar
  13. 13.
    Kärki A, Simonen R, Mälkiä E, Selfe J (2005) Impairments, activity limitations and participation restrictions 6 and 12 months after breast cancer operation. J Rehabil Med 37:180–188PubMedGoogle Scholar
  14. 14.
    Ko DSC, Lerner R, Klose G, Cosimi AB (1998) Effective treatment of lymphoedema of the extremities. Arch Surg 133:452–458PubMedCrossRefGoogle Scholar
  15. 15.
    Leduc O, Leduc A, Bourgeois P, Belgrado JP (1998) The physical treatment of upper limb edema. Cancer 83(12 Suppl American):2835–2839PubMedCrossRefGoogle Scholar
  16. 16.
    Liao SF, Huang MS, Li SH, Chen IR, Wei TS, Kuo SJ, Chen ST, Hsu JC (2004) Complex decongestive physiotherapy for patients with chronic cancer-associated lymphedema. J Formos Med Assoc 103:344–348PubMedGoogle Scholar
  17. 17.
    Liang HW, Wang HK, Yao G, Horng YS, Hou SM (2004) Psychometric evaluation of the Taiwan version of the disability of the arm, shoulder, and hand (DASH) questionnaire. J Formos Med Assoc 103:773–779PubMedGoogle Scholar
  18. 18.
    Liu NF, Olszewski W (1992) Use of tonometry to assess lower extremity lymphedema. Lymphology 25:155–158PubMedGoogle Scholar
  19. 19.
    Maunsell E, Brisson J, Deschènes L (1992) Arm problems and psychological distress after surgery for breast cancer. Can J Surg 36:315–320Google Scholar
  20. 20.
    McKenzie DC, Kalda AL (2003) Effect of upper extremity exercise on secondary lymphedema in breast cancer patients: a pilot study. J Clin Oncol 21:463–466PubMedCrossRefGoogle Scholar
  21. 21.
    Megens AM, Harris SR, Kim-Sing C, McKenzie DC (2001) Measurement of upper extremity volume in women after axillary dissection for breast cancer. Arch Phys Med Rehabil 82:1639–1644PubMedCrossRefGoogle Scholar
  22. 22.
    Mondry TE, Riffenburgh RH, Johnstone PA (2004) Prospective trial of complete decongestive therapy for upper extremity lymphedema after breast cancer therapy. Cancer J 10:42–48PubMedCrossRefGoogle Scholar
  23. 23.
    Motimer PS, Bates DO, Brassington HD, Stanton AWB, Strachan DP, Levick JR (1996) The prevalence of arm oedema following treatment for breast cancer. Q J Med 89:377–380Google Scholar
  24. 24.
    Nagi SZ (1964) A study in the evaluation of disability and rehabilitation potential: concepts, methods, and procedures. Am J Public Health Nations Health 54:1568–1579PubMedCrossRefGoogle Scholar
  25. 25.
    Pain SJ, Purushotham AD (2000) Lymphoedema following surgery for breast cancer. Br J Surg 87:1128–1141PubMedCrossRefGoogle Scholar
  26. 26.
    Passik SD, McDonald MV (1998) Psychosocial aspects of upper extremity lymphedema in women treated for breast carcinoma. Cancer 83(12 Suppl American):2817–2820PubMedCrossRefGoogle Scholar
  27. 27.
    Pierce CA, Hanks RA (2006) Life satisfaction after traumatic brain injury and the World Health Organization model of disability. Am J Phys Med Rehabil 85:889–898PubMedCrossRefGoogle Scholar
  28. 28.
    Rietman JS, Dijkstra PU, Debreczeni R, Geertzen JHB, Robinson DPH, De Vries J (2004) Impairments, disabilities and health related quality of life after treatment for breast cancer: a follow-up study 2.7 years after surgery. Disabil Rehabil 26:78–84PubMedCrossRefGoogle Scholar
  29. 29.
    Sander AP, Hajer NM, Hemenway K, Miller AC (2002) Upper-extremity volume measurements in women with lymphedema: a comparison of measurements obtained via water displacement with geometrically determined volume. Phys Ther 82:1201–1212PubMedGoogle Scholar
  30. 30.
    Segerström K, Bjerle P, Nystrom A (1991) Importance of time in assessing arm and hand function after treatment of breast cancer. Scand J Plast Reconstr Surg Hand Surg 25:241–244PubMedCrossRefGoogle Scholar
  31. 31.
    Szuba A, Achalu R, Rockson SG (2002) Decongestive lymphatic therapy for patients with breast carcinoma-associated lymphedema. A randomized, prospective study of a role for adjunctive intermittent pneumatic compression. Cancer 95:2260–2267PubMedCrossRefGoogle Scholar
  32. 32.
    Szuba A, Cooke JP, Yousuf S, Rockson SG (2000) Decongestive lymphatic therapy for patients with cancer-related or primary lymphedema. Am J Med 109:296–300PubMedCrossRefGoogle Scholar
  33. 33.
    Tobin MB, Lacey HJ, Meyer L, Mortimer PS (1993) The psychological morbidity of breast cancer-related arm swelling. Psychological morbidity of lymphoedema. Cancer 72:3248–3252PubMedCrossRefGoogle Scholar
  34. 34.
    Taylor R, Jayasinghe UW, Koelmeyer L, Ung O, Boyages J (2006) Reliability and validity of arm volume measurements for assessment of lymphedema. Phys Ther 86:205–214PubMedGoogle Scholar
  35. 35.
    Tsai HJ, Liu YX, Tsauo JY (2005) Reliability study of lymphedema measurement. Formos J Phys Ther 30:124–131Google Scholar
  36. 36.
    Williams AF, Vadgama A, Franks PJ, Mortimer PS (2002) A randomized controlled crossover study of manual lymphatic drainage therapy in women with breast cancer-related lymphoedema. Eur J Cancer Care 11:254–261CrossRefGoogle Scholar
  37. 37.
    World Health Organization (1980) International classification of impairments, disabilities, and handicaps: a manual of classification relating to the consequences of disease. World Health Organization, GenevaGoogle Scholar
  38. 38.
    World Health Organization (2001) ICF-International classification of functioning, disability and health. WHO Library, GenevaGoogle Scholar

Copyright information

© Springer-Verlag 2010

Authors and Affiliations

  • Jau-Yih Tsauo
    • 1
  • Hsiu-Chuan Hung
    • 1
  • Han-Ju Tsai
    • 1
  • Chiun-Sheng Huang
    • 2
    Email author
  1. 1.School and Graduate Institute of Physical Therapy, College of MedicineNational Taiwan UniversityTaipeiTaiwan
  2. 2.Department of Surgery, College of MedicineNational Taiwan University and HospitalTaipeiTaiwan

Personalised recommendations