Upper Extremity Function In Elderly Patients With Breast Cancer-Related Lymphedema: A Descriptive Study

Abstract

Introduction: Lymphedema is a common complication following breast cancer treatment with physical and pyschosocial consequences. The detrimental effects of lymphedema may become more disabiling in conjuction with the aging process. The aim of the study was to evaluate upper extremity function in elderly with breast cancer-related lymphedema and investigate the associations between upper limb function and demographic/clinical characteristics. Materials and Method: Eight-four women with a mean age of 65.1 +/- 5.0 years were enrolled in this study. Demograpic characteristics including age, body mass index, dominant hand, marital status, education level, and occupation were recorded. Cancer and lymphedema-related clinical features were reviewed. The disabilities of arm, shoulder, and hand (DASH) questionnaire was used to assess upper extremity function. Results: The mean of patients' body mass index was 31.9 +/- 6.1 kg/cm(2). The median duration of lymphedema was 8 months. Approximately 60% of patients had stage 2 lymphedema. The median value of interlimb volume difference was 558.5 ml. DASH score correlated only with body mass index, volume difference, and lymphedema stage. On regression analysis, the best predictors of upper extremity function in patients with lymphedema were found to be as body mass index and volume difference. Conclusion: The presence of breast cancer-related lymphedema negatively affects upper extremity function in elderly patients. The findings indicate that patients with higher body mass index and interlimb volume difference have more severe disability. Therefore, multimodal therapeutic interventions for reducing volume of the affected arm as well as body mass index could improve upper extremity function in older patients with lymphedema.