Upper limb function and quality of life in breast cancer related lymphedema: a cross-sectional study.

BACKGROUND: One of the most frequent impairments in breast cancer survivors is secondary lymphedema of the upper limbs. Several impairments and activity limitations frequently occur in these patients leading to participation restrictions and influencing Quality of Life. AIM: To investigate upper limb disability and perceived Health Related Quality of Life (HRQoL) in a group of women with breast cancer related lymphedema (BCRL) compared with a group without lymphedema. DESIGN: Cross-sectional survey. SETTING: Cancer outpatient's department of the National Cancer Institute of Naples Foundation "G. Pascale". POPULATION: 100 women treated with unilateral axillary lymphoadenectomy: 50 with unilateral BCRL (group A), and 50 without lymphedema (group B). METHODS: Arm function was assessed by the Disability of the Arm, Shoulder and Hand questionnaire (DASH). The perceived HRQoL was evaluated with SF-12. RESULTS: The mean DASH score was 36.59 (±18.03) in group A, and 23.68 (±21.46) in group B (P<0.002). Age less than 65 years, BMI≥30, the presence of comorbidities and radical mastectomy had an influence on the extent of the functional limitation, linked to the presence of the lymphedema. There were no statistically significant differences for SF-12 scores. CONCLUSION: In our population the presence of BCRL certainly affects upper limb functioning and related activities even though HRQoL was not perceived differently. CLINICAL REHABILITATION IMPACT: Lymphedema has to be early diagnosed and treated with an adequate rehabilitative plan to prevent activity limitations and participation restrictions.