Lymphedema, musculoskeletal events and arm function in older patients receiving adjuvant chemotherapy for breast cancer (Alliance A171302) Journal Article


Authors: Hopkins, J. O.; Allred, J.; Hurria, A.; Jatoi, A.; Lafky, J. M.; Cohen, H.; Hudis, C.; Winer, E.; Mandelblatt, J.; Partridge, A.; Carey, L.; Muss, H. B.
Article Title: Lymphedema, musculoskeletal events and arm function in older patients receiving adjuvant chemotherapy for breast cancer (Alliance A171302)
Abstract: Purpose: Musculoskeletal events (MEs) resulting from breast cancer treatment can significantly interfere with the quality of life (QOL) of older adults. We evaluated the incidence of MEs in women 65 years and older who had surgery and adjuvant chemotherapy for breast cancer, and the impact of treatment on MEs and arm function. Patients and methods: Patient-reported data in Alliance/CALGB 49907 were collected using the EORTC QLQ-BR23 and physician-reported adverse events to characterize self-reported MEs and incidence of lymphedema. EORTC QLQ-BR23 items related to musculoskeletal events were analyzed in this study and data collected at study entry (post-operative) and 12 and 24 months post-entry. Results: Lymphedema, arm function, and ME data were available for 321 patients. One or more MEs were reported by 87% (median number = 3) and 64% (median number = 1) of patients post-operatively and at 24 months. At 24 months 2% had persistence of six MEs. Seventy-four percent experienced at least ≥3/6 types of MEs over the 24-month period. Detection of lymphedema at any time during the study was noted in 7.5% of the patients and appeared to be associated with the type of chemotherapy given: CMF 16.4%, capecitabine 5.8%, and AC 4%. Mastectomy and axillary node dissection were associated with the most MEs. LROM correlated with poorer arm function at all time periods. Conclusion: Potentially debilitating MEs occur in three-fourths of elderly women undergoing standard therapy for breast cancer. Emphasis should be placed on prevention, identification, and treatment of these MEs to improve QOL. © 2017, Springer Science+Business Media, LLC.
Keywords: controlled study; aged; arm movement; cancer surgery; major clinical study; postoperative period; doxorubicin; fluorouracil; capecitabine; cancer adjuvant therapy; methotrexate; lymph node dissection; quality of life; breast cancer; mastectomy; cyclophosphamide; self report; lymphedema; elderly; musculoskeletal disease; human; female; priority journal; article; musculoskeletal events
Journal Title: Breast Cancer Research and Treatment
Volume: 166
Issue: 3
ISSN: 0167-6806
Publisher: Springer  
Date Published: 2017-12-01
Start Page: 793
End Page: 808
Language: English
DOI: 10.1007/s10549-017-4454-7
PROVIDER: scopus
PUBMED: 28825227
PMCID: PMC5771504
DOI/URL:
Notes: Article -- Export Date: 2 January 2018 -- Source: Scopus
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  1. Clifford Hudis
    905 Hudis