Document Type

Dissertation

Publication Date

2-6-2013

Abstract

Many women who have experienced breast cancer (BC) report continued impairments in upper extremity (UE) function beyond the time required for normal healing after surgical treatment. Most research supporting this has not made comparisons between survivors of breast cancer (BCS) to a sample of healthy women. This lack of comparison to a healthy cohort prevents an understanding of whether continued deficits in UE function are due to normal aging or the BC treatment.

The purpose of this research was to compare quality of life (QOL) and UE function among long term breast cancer survivors and similar aged women without cancer. Both self-report and objective measurements of UE function were used to create an understanding of UE functional abilities in both populations.

Data on self-reported QOL and UE function, ROM, strength, and muscular endurance were collected on 79 healthy women ages 30-69, stratified by decade. Comparisons between decades and between dominant and non-dominant limbs were made. Findings supported no effect of aging on measures, and that dominance does affect some objective measures of motion, strength, and muscular endurance.

A group of 42 survivors of breast cancer (BCS) were compared to the data from healthy controls on the same measures. BCS reported lower levels of QOL and UE function, and demonstrated less motion and strength than the healthy cohort, particularly when cancer occurred on the non-dominant limb. The values of the measures, however, are not clinically relevant, and reveal that BCS 6 years after treatment recover UE function to levels similar to healthy controls.

In view of a lack of clinically feasible measures of UE muscular endurance, a new test to assess this was designed and implemented: the modified Upper Body Strength and Endurance test (mUBSE). It was believed this new test would be less variable than the Functional Impairment Test – Hand and Neck, Shoulder, Arm – FIT-HaNSA. Seventeen BCS and 17 matched controls were compared on the mUBSE and FIT-HaNSA. Findings were similar for both tests. Furthermore, BCS who are 6 years post BC treatment appear to recover muscular endurance levels to normal ranges.

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Comments

Dedication

This work is dedicated to the many women who have experienced life beyond breast cancer, and helped me understand its implications on a personal level.

To the woman who was my first teacher and the first breast cancer survivor I knew, for her enduring strength amidst life’s hurdles, Carmella Insana. She is first and foremost my mother.

To Shelley Colbert, who died from breast cancer while I was working on this project, for the love and care she provided to my children while I pursued this research.

And lastly, to all of the women who participated in my research, for their willingness to give of their time that we might learn in order to improve the quality of life of future breast cancer survivors.

It was through the efforts of these special women that I am successful not only in earning this degree, but gaining a depth of understanding beyond the experience itself.

Keywords

Breast cancer, quality of life, upper extremity function, range of motion and strength, muscular endurance