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Risk factors for reduced function in women with a history of breast cancer

  • Epidemiology
  • Published:
Breast Cancer Research and Treatment Aims and scope Submit manuscript

Abstract

Purpose

People with a history of breast cancer are at risk of losing function during and after treatment. Unfortunately, little is known about the individual and additive effects of specific treatment, disease-related, and demographic factors that may contribute to functional decline. This manuscript reports the results of a multi-center study to evaluate the effects of these factors on function.

Methods

In this cross-sectional study, women with a history of breast cancer referred to physical medicine and rehabilitation cancer rehabilitation clinics were administered the PROMIS® Cancer Function Brief 3D Profile to evaluate function in the domains of physical function, fatigue, and social participation. Clinical and demographic information, including treatment history and disease status, was recorded by clinicians. Patients were analyzed in two groups: those with active disease on antineoplastic treatment, and those with no evidence of disease (NED). A multivariable model was constructed to detect associations between clinical and demographic factors.

Results

In patients with NED, the presence of chemotherapy-induced peripheral neuropathy (CIPN) was strongly associated with reduced function in all three domains. In those with active disease, having brain metastases was significantly associated with reduced function in all domains and CIPN with reduced physical function. Radiation was associated with improved function in both cohorts.

Conclusions

Among women seeking rehabilitative care, CIPN and the presence of brain metastases were most strongly associated with a decline in function. The effects of radiation on function were unexpected and may be partially explained by the treatment’s role in symptom management. Clinicians who treat breast cancer should consider a patient’s functional status when providing supportive care.

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Data availability

Available upon request. Currently curated by the University of Michigan.

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Acknowledgements

None.

Funding

This study was funded in part by a grant from the Foundation for Physical Medicine and Rehabilitation.

Author information

Authors and Affiliations

  1. Department of Physical Medicine and Rehabilitation, University of Michigan, 325 E Eisenhower Pkwy, Ste 100, Ann Arbor, MI, 48108, USA

    Nicholas Stoyles, Gina Jay & Sean R. Smith

  2. Department of Physical Medicine and Rehabilitation, Mayo Clinic, Rochester, MN, USA

    Andrea Cheville

  3. Cancer Rehabilitation Medicine Services, Swedish Cancer Institute, Swedish Health Services, Seattle, WA, USA

    David Zucker

  4. Michigan Institute for Clinical and Health Research, University of Michigan, Ann Arbor, MI, USA

    Blair Richards

  5. Case Western Reserve University, Cleveland, OH, USA

    Mary Vargo

  6. George Mason University, Fairfax, VA, USA

    Lynn Gerber

  7. Shirley Ryan Ability Lab, Chicago, IL, USA

    Samman Shahpar

  8. University of Pittsburgh Medical Center, Pittsburgh, PA, USA

    Maryanne Henderson

Authors
  1. Nicholas Stoyles
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  2. Andrea Cheville
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  3. David Zucker
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  4. Blair Richards
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  5. Mary Vargo
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  6. Lynn Gerber
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  7. Samman Shahpar
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  8. Maryanne Henderson
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  9. Gina Jay
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  10. Sean R. Smith
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Contributions

Conceptualization, methodology, formal analysis, writing, data curation; SRS: conceptualization, methodology, formal analysis, investigation, writing, visualization, supervision, data acquisition, funding acquisition; MV: conceptualization, investigation, data acquisition, writing; DZ: conceptualization, methodology, data acquisition, investigation, writing; BR: statistical analysis, visualization; SS: conceptualization, data acquisition, investigation, writing; LG: conceptualization, methodology, writing; MH: conceptualization, investigation, writing; GJ: validation, data curation, project administration; AC: conceptualization, data acquisition, methodology, writing.

Corresponding author

Correspondence to Sean R. Smith.

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Conflict of interest

This was reviewed with all authors, and there are no relevant financial or commercial conflicts of interest.

Ethical approval

This study was performed in line with the principles of the Declaration of Helsinki. Approval was granted by the Ethics Committee at each institution that participated in data collection.

Consent to participate

Informed consent was obtained from all individual participants included in the study.

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Stoyles, N., Cheville, A., Zucker, D. et al. Risk factors for reduced function in women with a history of breast cancer. Breast Cancer Res Treat 197, 613–621 (2023). https://doi.org/10.1007/s10549-022-06838-3

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  • DOI: https://doi.org/10.1007/s10549-022-06838-3

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