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Journal of Cancer Survivorship

, Volume 4, Issue 1, pp 15–19 | Cite as

The role of occupational upper extremity use in breast cancer related upper extremity lymphedema

  • Gulgun Tahan
  • Ronald Johnson
  • Lisa Mager
  • Atilla SoranEmail author
Article

Abstract

Background

Upper extremity (UE) use has been related to breast cancer-related lymph edema (BCRL). Our aim was to evaluate severity of BCRL in different occupation groups, according to upper extremity use.

Methods

Fifty-five women with BCRL were recruited. Group-1 (n = 21), with a mean age of 59, included patients who worked continuously <30 min at a time and ≤8 h per day. Group-2 (n = 15), with a mean age of 54, were patients who worked continuously between 30 to 60 min at a time, and ≤8 h per day. Group-3 (n = 19), who had a mean age of 51, included patients who were working continuously for >1 h and >8 h per day.

Results

The age, operation type, infection occurrence, radiotherapy status, and the operation on the side of the dominant hand were not statistically different between the groups. The stage and grade of the BCRL in group-3 were higher than the other groups (both p < 0.001). The restriction of shoulder movements on the operation side (p = 0.04) and shoulder physiotherapy need (p < 0.001) were the highest in group-3. Arm pain (p = 0.004) and pain medicine needs (p = 0.028) in group-1 were lower than the other groups.

Conclusion

Group-3 had the worst BCRL clinical stage and grade status and other breast cancer treatment related morbities. Occupations that require greater use of the upper extremities.

At present there is a need for closer monitoring of patients with more severe BCRL. Potential exacerbating and maintaining factors of functional limitations and pain need to considered so that clinical management addresses these in relation to daily use of the affected UE.

Keywords

Breast cancer Lymphedema Stage Occupation 

References

  1. 1.
    Soran A, D’Angelo G, Begovic M, Ardic F, Harlak A, Samuel Wieand H, et al. Breast cancer-related lymphedema-what are the significant predictors and how do they affect the severity of lymphedema? Breast J. 2006;12:536–43.CrossRefPubMedGoogle Scholar
  2. 2.
    Schrenk P, Rieger R, Shamiyeh A, Wayand W. Morbidity following sentinel lymph node biopsy versus axillary lymph node dissection for patients with breast carcinoma. Cancer. 2000;88:608–14.CrossRefPubMedGoogle Scholar
  3. 3.
    Vignes S, Arrault M, Dupuy A. Factors associated with increased breast cancer-related lymphedema volume. Acta Oncol. 2007;46:1138–42.CrossRefPubMedGoogle Scholar
  4. 4.
    Hayes SC, Janda M, Cornish B, Battistutta D, Newman B. Lymphedema after breast cancer: incidence, risk factors, and effect on upper body function. J Clin Oncol. 2008;26:3536–42.CrossRefPubMedGoogle Scholar
  5. 5.
    McLaughlin SA, Wright MJ, Morris KT, Sampson MR, Brockway JP, Hurley KE, et al. Prevalence of lymphedema in women with breast cancer 5 years after sentinel lymph node biopsy or axillary dissection: patient perceptions and precautionary behaviors. J Clin Oncol. 2008;26:5220–6.CrossRefPubMedGoogle Scholar
  6. 6.
    Swenson KK, Nissen MJ, Leach JW, Post-White J. Case-control study to evaluate predictors of lymphedema after breast cancer surgery. Oncol Nurs Forum. 2009;36:185–93.CrossRefPubMedGoogle Scholar
  7. 7.
    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;35:65–71.CrossRefPubMedGoogle Scholar
  8. 8.
    Gur SA, Unal B, Ahrendt G, Gimbel ML, Kayiran O, Johnson R, et al. Risk factor for breast cancer-related upper extremity: is immediate autologous breast reconstruction one of them? Cent Eur J Med. 2009;4:65–70.CrossRefGoogle Scholar
  9. 9.
    United States Department of Labor, Bureau of Labor Statistics: Standard Occupation Classification. http://www.bls.gov/SOC.
  10. 10.
    Lymphedema management: the comprehensive guide for practitioners. In: Zuther JE, editor, Sebastian, Florida. Thieme Medical Publishers, February 2005. Chapter 3 Pathology p. 53–57.Google Scholar
  11. 11.
    Ronka RH, Pamilo MS, Von Smitten KA, Leidenius MH. Breast lymphedema after breast conserving treatment. Acta Oncol. 2004;43:551–7.CrossRefPubMedGoogle Scholar
  12. 12.
    Goffman TE, Laronga C, Wilson L, Elkins D. Lymphedema of the arm and breast in irradiated breast cancer patients: risks in an area of dramatically changing axillary surgery. Breast J. 2004;10:405–11.CrossRefPubMedGoogle Scholar
  13. 13.
    Hinrichs CS, Watroba NL, Rezaishiraz H, Giese W, Hurd T, Fassl KA, et al. Lyhedema secondary to post mastectomy radiation: incidence and risk factors. Ann Surg Oncol. 2004;11:573–80.CrossRefPubMedGoogle Scholar
  14. 14.
    Petrek JA, Pressman PI, Smith RA. Lymphedema: current issues in research and management. CA Cancer J Clin. 2000;50:292–307.CrossRefPubMedGoogle Scholar
  15. 15.
    Pain SJ, Prushotham AD. Lymphedema following surgery for breast cancer. Br J Surg. 2000;87:1128–41.CrossRefPubMedGoogle Scholar
  16. 16.
    Kocak Z, Overgaard J. Risk factors of arm lymphedema in breast cancer patient. Acta Oncol. 2000;39:389–92.CrossRefPubMedGoogle Scholar
  17. 17.
    Erickson VS, Pearson ML, Ganz PA, Adams J, Kahn KL. Arm edema in breast cancer patient. J Natl Cancer Ins. 2001;93:96–111.CrossRefGoogle Scholar
  18. 18.
  19. 19.
    Schmitz KH, Ahmed RL, Troxel A, Cheville A, Smith R, Lewis-Grant L, et al. Weight lifting in women with breast-cancer-related lymphedema. N Engl J Med. 2009;361:664–73.CrossRefPubMedGoogle Scholar
  20. 20.
    Meek AG. Breast radiotherapy and lymhedema. Cancer. 1998;83(12 Suppl American):2788–97.CrossRefPubMedGoogle Scholar
  21. 21.
    Kiel KD, Rademacker AW. Early stage breast cancer: arm edema after wide excision and breast irradiation. Radiology. 1996;198:279–83.PubMedGoogle Scholar
  22. 22.
    Pezner RD, Patterson MP, Hill LR, Lipsett JA, Desai KR, Vora N, et al. Arm lymphedema in patients treated conservatively for breast cancer: relationship to patient age and axillary node dissection technique. Int J Radiat Oncol Biol Phys. 1986;12:2079–83.PubMedGoogle Scholar
  23. 23.
    Werner RS, McCormick B, Petrek J, Cox L, Cirrincione C, Gray JR, et al. Arm edema in conservatively managed breast cancer: obesity is a major predictive factor. Radiology. 1991;180:177–84.PubMedGoogle Scholar
  24. 24.
    Mozes M, Papa MZ, Karasik A, Reshef A, Adar R. The role of infection in postmastectomy lymphedema. Ann Surg. 1982;14:73–83.Google Scholar
  25. 25.
    Kopanski Z, Wojewoda T, Wojewoda A, Schlegel-Zawadzka M, Wozniacka R, Suder A, et al. Influence of some anthropometric parameters on the risk of development of distal complications after mastectomy carried out because of breast carcinoma. Am J Hum Biol. 2003;15:433–9.CrossRefPubMedGoogle Scholar
  26. 26.
    Johansson K, Ohlsson K, Ingvar C, Albertsson M, Ekdahl C. Factors associated with the development of arm lymphedema following breast cancer treatment: a match pair case-control study. Lymphology. 2002;35:5971.Google Scholar
  27. 27.
    Segerstrom K, Bjerle P, Graffman S, Nystrom A. Factors that influence the incidence of breast cancer. Scand J Plast Recons Hand Surg. 1992;26:223–7.CrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC 2009

Authors and Affiliations

  • Gulgun Tahan
    • 1
  • Ronald Johnson
    • 1
  • Lisa Mager
    • 2
  • Atilla Soran
    • 1
    • 3
    Email author
  1. 1.Department of Surgery, Surgical OncologyMagee-Womens Hospital of University of PittsburghPittsburghUSA
  2. 2.Centers for Rehabilitation ServicesUniversity of Pittsburgh Medical CenterPittsburghUSA
  3. 3.Magee-Womens Hospital of UPMCPittsburghUSA

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