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Arm/hand swelling and perceived functioning among breast cancer survivors 12 years post-diagnosis: CALGB 79804

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Abstract

Introduction

Lymphedema is an under-reported and debilitating consequence of axillary node dissection among breast cancer survivors. This study describes the characteristics of arm and hand swelling in relation to perceived physical and mental health functioning among breast cancer survivors 9–16 years post-diagnosis who previously participated in a clinical trial coordinated by the Cancer and Leukemia Group B (CALGB 8541).

Methods

Eligible survivors of CALGB 8541 completed questionnaires assessing demographics, arm/hand swelling, perceived physical functioning, and mental health.

Results

Two hundred forty-five women (94% white, mean age = 63, on average 12.4 years post-diagnosis) completed questionnaires (participation rate = 78%). Seventy-five women (31%) reported arm/hand swelling since their surgery. Of these women, 76% reported current swelling and half reported constant swelling, mainly in the upper arm. Swelling was reported as mild or moderate in 88% of the women. Women who reported severe swelling had significantly worse physical functioning and trended toward worse depressive symptoms and poorer mental health (lower mental SF-36 scores) as well. Activity-limiting swelling was also significantly associated with worse physical functioning. Although swelling interfered with wearing clothing (36%) and perceptions about general appearance (32%), only 37% of women sought treatment for swelling.

Conclusions

Arm/hand swelling is a chronic problem for a subgroup of long-term survivors of breast cancer, negatively affecting physical functioning.

Implications for cancer survivors

Educational efforts are needed as part of a comprehensive survivorship care plan to raise awareness about lymphedema so that survivors may identify this complication, seek treatment early, and potentially improve their physical functioning.

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Author information

Authors and Affiliations

  1. Comprehensive Cancer Center, The Ohio State University, A356 Starling-Loving Hall, 320 W. 10th Avenue, Columbus, OH, USA

    Jill M. Oliveri, Catherine M. Alfano, Mira L. Katz, Marisa A. Bittoni & Electra D. Paskett

  2. CALGB Statistical Center, Duke University Medical Center, Durham, NC, USA

    Jeannette M. Day, James E. Herndon II & Kathleen Donohue

  3. College of Public Health, The Ohio State University, Columbus, OH, USA

    Catherine M. Alfano, Mira L. Katz & Electra D. Paskett

Authors
  1. Jill M. Oliveri
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  8. Electra D. Paskett
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Corresponding author

Correspondence to Electra D. Paskett.

Additional information

The research for CALGB 79804 was supported, in part, by grants from the National Cancer Institute (CA31946) to the Cancer and Leukemia Group B (Richard L. Schilsky, MD, Chairman) and to the CALGB Statistical Center (Stephen George, PhD, CA33601). The content of this manuscript is solely the responsibility of the authors and does not necessarily represent the official views of the National Cancer Institute. In addition this research was funded by the National Institutes of Health Grants: AG16602, CA79883, CA57707, and CA131029.

CALGB Statistical Office, Durham, NC—Stephen George, Ph.D.; supported by CA33601

Christiana Care Health Services, Inc. CCOP, Wilmington, DE—Irving M. Berkowitz, D.O.; supported by CA45418

Dana Farber Cancer Institute, Boston, MA—George P Canellos, M.D.; supported by CA32291

Dartmouth Medical School—Norris Cotton Cancer Center, Lebanon, NH—Marc S. Ernstoff, M.D.; supported by CA04326

Duke University Medical Center, Durham, NC—Jeffrey Crawford, M.D.; supported by CA47577

Massachusetts General Hospital, Boston, MA—Michael L. Grossbard, M.D.; supported by CA12449

Mount Sinai School of Medicine, New York, NY—Lewis R. Silverman, M.D.; supported by CA04457

North Shore—Long Island Jewish Medical Center, Manhasset, NY, Daniel R Budman, M.D., supported by CA35279

Rhode Island Hospital, Providence, RI—Louis A. Leone, M.D.; supported by CA08025

Roswell Park Cancer Institute, Buffalo, NY—Ellis Levine, M.D.; supported by CA02599

Southeast Cancer Control Consortium Inc. CCOP, Goldsboro, NC—James N. Atkins, M.D.; supported by CA45808

Southern Nevada Cancer Research Foundation CCOP, Las Vegas, NV—John Ellerton, M.D.; supported by CA35421

SUNY Upstate Medical University, Syracuse, NY—Stephen L. Graziano, M.D.; supported by CA21060

Syracuse Hematology–Oncology Assoc. CCOP, Syracuse, NY, Jeffrey Kirshner, M.D., supported by CA45389

University of California at San Diego, San Diego, CA—Stephen L Seagren, M.D.; supported by CA11789

University of Chicago Medical Center, Chicago, IL—Gini Fleming, M.D.; supported by CA41287

University of Maryland Cancer Center, Baltimore, MD—David Van Echo, M.D.; supported by CA31983

University of Massachusetts Medical Center, Worcester, MA, Mary Ellen Taplin, M.D., supported by CA37135

University of Minnesota, Minneapolis, MN—Bruce A Peterson, M.D.; supported by CA16450

University of Missouri/Ellis Fischel Cancer Center, Columbia, MO—Michael C Perry, M.D.; supported by CA12046

University of North Carolina at Chapel Hill, Chapel Hill, NC—Thomas C. Shea, M.D.; supported by CA47559

Wake Forest University School of Medicine, Winston-Salem, NC—David D Hurd, M.D.; supported by CA03927

Walter Reed Army Medical Center, Washington, DC—Joseph J. Drabeck, M.D.; supported by CA26806

Washington University School of Medicine, St. Louis, MO, Nancy Bartlett, MD, supported by CA77440

Jill M. Oliveri, Catherine M. Alfano, Mira L. Katz, Marisa A. Bittoni, and Electra D. Paskett were supported by CA77658.

Jeannette M. Day2, James E. Herndon II, and Kathleen Donohue2 were supported by CA33601.

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Oliveri, J.M., Day, J.M., Alfano, C.M. et al. Arm/hand swelling and perceived functioning among breast cancer survivors 12 years post-diagnosis: CALGB 79804. J Cancer Surviv 2, 233–242 (2008). https://doi.org/10.1007/s11764-008-0065-y

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