Long-Term Follow-Up of Upper-Body Function Among Breast Cancer Survivors

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Abstract
We enrolled a cohort of 303 stage I or stage II breast cancer patients diagnosed in Boston, MA, between October 1992 and December 1995. We followed the patients by interview and medical record abstract for 5 years (a) to characterize the incidence and predictors of upper‐body function decline and (b) to characterize the incidence and predictors of recovery of upper‐body function. The incidence of decline in the first year after therapy (17.7/100 person years) was substantially higher than in the subsequent 4 years of follow‐up (11.0/100 person‐years, p value for test of homogeneity equal 0.028). With only one exception, no patient characteristic, therapy component, or disease trait was associated with decline over the full follow‐up period. Women with less than a high school education had an adjusted relative hazard of decline of 2.3 (95% CI, 1.4–3.7) compared with women with a high school education or more, possibly reflecting occupational or environmental insults that predispose to functional impairment. Women who had reported a decline in upper‐body function and who subsequently saw their breast cancer specialist were 4.8‐fold more likely to report that they had recovered their upper‐body function at their next interview (95% CI, 2.0, 12). This finding suggests that attention to upper‐body function during follow‐up visits may facilitate recovery.

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