scholarly journals The influence of breast cancer-related lymphedema on women's return-to-work

2018 ◽  
Author(s):  
◽  
Yuanlu Sun
Keyword(s):  
Breast Cancer ◽  
Environmental Factors ◽  
Return To Work ◽  
Work Experience ◽  
Breast Cancer Survivors ◽  
Develop Breast Cancer ◽  
International Classification Of Functioning ◽  
Personal Factors ◽  
Breast Cancer Patients ◽  
Breast Cancer Related Lymphedema

The majority of women who develop breast cancer are under retirement age. Therefore, occupational functioning and employment are issues of significant concern. Breast cancer-related lymphedema (BCRL) is one of the major treatment complications for breast cancer patients and it has been shown to be associated with adverse work outcomes. This study is one of the first to ask "how and why" lymphedema may interact with breast cancer survivors' return-to-work. The International Classification of Functioning, Disability, and Health (ICF), which was adopted to guide research design and analysis of data related to health outcomes, was used as a platform for thinking about the phenomenon of return-to-work. Case study methodologies drawn from Yin's (2014) definition were employed in this dissertation study. Thirteen women with BCRL were enrolled in this study. Participants completed a survey and then participated in a sixty-minute semi-structured individual interview. The results suggested that the return-to-work experience was shaped by interactions of the disease processes, the work activities required, the individual, and an array of environmental factors. Four main themes emerged: 1) BCRL affects physical and emotional functioning associated with work; 2) On-going treatment for BCRL creates challenges for work; 3) Environmental factors affect the work experience; and 4) Personal factors play a key role in adjusting to return-to-work. The findings shared considerable agreement with ICF model and suggested new perspectives towards understanding the model. This study suggests implications for BCRL education, clinical practice, health policy, and research.

scholarly journals The influence of breast cancer related lymphedema on women’s return-to-work

2020 ◽  
Vol 16 ◽  
pp. 174550652090572 ◽  
Author(s):  
Yuanlu Sun ◽  
Cheryl L Shigaki ◽  
Jane M Armer
Keyword(s):  
Breast Cancer ◽  
Return To Work ◽  
Work Experience ◽  
Breast Cancer Survivors ◽  
Structured Interview ◽  
Develop Breast Cancer ◽  
Breast Cancer Surgery ◽  
Personal Factors ◽  
Case Study Methodology ◽  
Breast Cancer Related Lymphedema

Background: Lymphedema is one of the major treatment complications following breast cancer surgery and radiation. As the majority of women who develop breast cancer are at the age of employment, occupational functioning and employment are issues of concern. This study is novel in exploring the ways that lymphedema affects their work experience. Methods: A multiple-case study methodology drawn from Yin’s definition was employed. A total of 13 female survivors who developed breast cancer–related lymphedema participated by completing a survey and a 60-min semi-structured interview. Results: Four main themes emerged: (1) breast cancer–related lymphedema affects physical and emotional functioning associated with work; (2) ongoing treatment for breast cancer–related lymphedema creates challenges for work; (3) environmental factors affect the return-to-work experience; and (4) personal factors play a key role in adjusting to return-to-work. Conclusion: Both breast cancer–related lymphedema and its treatment have direct and indirect effects on work, with environmental and personal factors also shaping the work-return experience. This study suggests that breast cancer survivors with lymphedema who wish to return to work face potential barriers, and that gaps remain in the availability of supports.

Correlates of Return to Work for Breast Cancer Survivors

2006 ◽  
Vol 24 (3) ◽  
pp. 345-353 ◽  
Author(s):  
Reynard R. Bouknight ◽  
Cathy J. Bradley ◽  
Zhehui Luo
Keyword(s):  
Breast Cancer ◽  
Return To Work ◽  
Cancer Survivors ◽  
Cancer Diagnosis ◽  
Odds Ratio ◽  
Breast Cancer Survivors ◽  
Breast Cancer Diagnosis ◽  
Breast Cancer Patients ◽  
Employer Discrimination ◽  
Employer Accommodation

PurposeTo identify correlates of return to work for employed breast cancer survivors.Patients and MethodsPatients included 416 employed women with newly diagnosed breast cancer identified from the Metropolitan Detroit Cancer Surveillance System. Patients were interviewed by telephone 12 and 18 months after diagnosis. Correlates of return to work at 12 and 18 months were identified using multivariate logistic regression.ResultsMore than 80% of patients returned to work during the study period, and 87% reported that their employer was accommodating to their cancer illness and treatment. After adjusting for demographic characteristics, health status, cancer stage, treatment, and job type, heavy lifting on the job (odds ratio = 0.42; 95% CI, 0.18 to 0.99), perceived employer accommodation for cancer illness and treatment (odds ratio = 2.2; 95% CI, 1.03 to 4.8), and perceived employer discrimination because of a cancer diagnosis (odds ratio = 0.27; 95% CI, 0.10 to 0.71) were independently associated with return to work at 12 months after breast cancer diagnosis, and perceived employer accommodation (odds ratio = 2.3; 95% CI, 1.06 to 5.1) was independently associated with return to work at 18 months after breast cancer diagnosis.ConclusionA high percentage of employed breast cancer patients returned to work after treatment, and workplace accommodations played an important role in their return. In addition, perceived employer discrimination because of cancer was negatively associated with return to work for breast cancer survivors. Employers seem to have a pivotal role in breast cancer patients' successful return to work.

Shared Responsibilities for Full Participation in Society: Planning Further Integration of the ICF Into AAC

2016 ◽  
Vol 1 (12) ◽  
pp. 83-93 ◽  
Author(s):  
Mary Blake Huer ◽  
Travis T. Threats
Keyword(s):  
Environmental Factors ◽  
Augmentative And Alternative Communication ◽  
Functional Limitations ◽  
Community Support ◽  
World Health ◽  
International Classification Of Functioning ◽  
Personal Factors ◽  
Social Service Agencies ◽  
Persons With Disabilities ◽  
Full Participation

The World Health Organization's (WHO's) 2001 International Classification of Functioning Disability and Health (ICF) has as one of its central tenets the full inclusion of persons with disabilities in society. It acknowledges the need for medical and rehabilitation intervention in its biopscychosocial framework. However, the WHO realizes that society must do its part to facilitate this full participation and empowerment. Persons with complex communication needs (PWCCN) often need augmentative and alternative communication (AAC) in order to express themselves. However, in order to access and successfully use AAC, PWCCN need access to the necessary AAC devices and services, as well as a willing society to interact with them as full contributing members of society. The factors outside of a person's specific physical and/or cognitive functional limitations are addressed in the ICF via the Personal and Environmental Factors. Personal Factors include the individual's personality traits, lifestyle, experiences, social/educational/professional background, race, gender, and age. Environmental Factors include community support systems, social service agencies, governments, social networks, and those persons that interact with the PWCCN. This article addresses the sociopolitical influences on PWCCN and their functioning from a human rights perspective. The necessary introspective role of speech-language pathologists in this process is explored.

scholarly journals Electronic Moxibustion for Breast Cancer-Related Lymphedema: A Pilot Clinical Trial

2020 ◽  
Vol 19 ◽  
pp. 153473542096285
Author(s):  
Kyungsun Han ◽  
Ojin Kwon ◽  
Hyo-Ju Park ◽  
Ae-Ran Kim ◽  
Boram Lee ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Clinical Trial ◽  
Range Of Motion ◽  
Upper Limb ◽  
Life Questionnaire ◽  
Breast Cancer Patients ◽  
Shoulder Range Of Motion ◽  
Breast Cancer Related Lymphedema ◽  
Shoulder Range

This is a preliminary study to investigate the feasibility of electronic moxibustion in breast cancer patients with upper limb lymphedema. As current treatment options for lymphedema are unsatisfactory and time consuming, there have been attempts to manage symptoms using integrative treatments. Electronic moxibustion was developed to compensate for the shortcomings of conventional moxibustion and is widely used in clinical practice. However, there have been no studies on using electronic moxibustion in breast cancer-related lymphedema. To investigate the feasibility of electronic moxibustion in treating breast cancer-related lymphedema, this study included subjects who completed primary cancer treatment at least 6 months ago and had more than 10 mm difference in arm circumference of upper limbs. All subjects were assigned to the treatment group. Subjects were treated with 16 sessions (30 minutes/session) of electronic moxibustion for 8 weeks followed by 4 weeks of follow-up. For outcome measures, upper limb circumferences, shoulder range of motion, bioimpedance analysis, and quality of life questionnaire were assessed. All 10 subjects completed the study. The effective index showed 38.21% reduction after treatment ( P = .0098) and 29.35% ( P = .0039) after 4 weeks of follow-up compared to the baseline. The reduction of lymphedema was most prominent at 10 cm above the elbow crease, where the mean reduction of circumference difference was 7.5 mm ( P = .0430) and continued to improve after treatment (mean reduction of 8.3 mm, P = .0156). There was significant improvement in shoulder range of motion only in flexion and internal rotation at week 9. There were 7 adverse events, and most were irrelevant to the treatment. Only 1 participant had a mild burn on the acupuncture point. Here, we demonstrate for the first time that electronic moxibustion treatment is a feasible treatment for breast cancer-related lymphedema. Electronic moxibustion may reduce differences in upper limb circumference and improve shoulder range of motion. A future comparative clinical trial is needed to confirm the clinical efficacy of this treatment.

scholarly journals Assessment of Potential Risk Factors and Skin Ultrasound Presentation Associated with Breast Cancer-Related Lymphedema in Long-Term Breast Cancer Survivors

Diagnostics ◽  
2021 ◽  
Vol 11 (8) ◽  
pp. 1303
Author(s):  
Khairunnisa’ Md Yusof ◽  
Kelly A. Avery-Kiejda ◽  
Shafinah Ahmad Suhaimi ◽  
Najwa Ahmad Zamri ◽  
Muhammad Ehsan Fitri Rusli ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Risk Factors ◽  
Cancer Survivors ◽  
Potential Risk ◽  
Breast Cancer Survivors ◽  
Ultrasound Examination ◽  
Arm Circumference ◽  
Potential Risk Factors ◽  
Breast Cancer Related Lymphedema

Breast cancer has been reported to have the highest survival rate among various cancers. However, breast cancer survivors face several challenges following breast cancer treatment including breast cancer-related lymphedema (BCRL), sexual dysfunction, and psychological distress. This study aimed to investigate the potential risk factors of BCRL in long term breast cancer survivors. A total of 160 female breast cancer subjects were recruited on a voluntary basis and arm lymphedema was assessed through self-reporting of diagnosis, arm circumference measurement, and ultrasound examination. A total of 33/160 or 20.5% of the women developed BCRL with significantly higher scores for upper extremity disability (37.14 ± 18.90 vs. 20.08 ± 15.29, p < 0.001) and a lower score for quality of life (103.91 ± 21.80 vs. 115.49 ± 16.80, p = 0.009) as compared to non-lymphedema cases. Univariate analysis revealed that multiple surgeries (OR = 5.70, 95% CI: 1.21–26.8, p < 0.001), axillary lymph nodes excision (>10) (OR = 2.83, 95% CI: 0.94–8.11, p = 0.047), being overweight (≥25 kg/m2) (OR = 2.57, 95% CI: 1.04 – 6.38, p = 0.036), received fewer post-surgery rehabilitation treatment (OR = 2.37, 95% CI: 1.05–5.39, p = 0.036) and hypertension (OR = 2.38, 95% CI: 1.01–5.62, p = 0.043) were associated with an increased risk of BCRL. Meanwhile, multivariate analysis showed that multiple surgeries remained significant and elevated the likelihood of BCRL (OR = 5.83, 95% CI: 1.14–29.78, p = 0.034). Arm swelling was more prominent in the forearm area demonstrated by the highest difference of arm circumference measurement when compared to the upper arm (2.07 ± 2.48 vs. 1.34 ± 1.91 cm, p < 0.001). The total of skinfold thickness of the affected forearm was also significantly higher than the unaffected arms (p < 0.05) as evidenced by the ultrasound examination. The continuous search for risk factors in specific populations may facilitate the development of a standardized method to reduce the occurrence of BCRL and provide better management for breast cancer patients.

scholarly journals Adherence and persistence to adjuvant hormonal therapy in early stage breast cancer patients: A population-based retrospective cohort study in Israel.

2017 ◽  
Vol 35 (15_suppl) ◽  
pp. e12051-e12051
Author(s):  
Tal Sella ◽  
Gabriel Chodick
Keyword(s):  
Breast Cancer ◽  
Cancer Patients ◽  
Hormonal Therapy ◽  
Breast Cancer Survivors ◽  
Early Stage ◽  
Population Based ◽  
Early Stage Breast Cancer ◽  
Adjuvant Hormonal Therapy ◽  
Breast Cancer Patients ◽  
Suboptimal Adherence

e12051 Background: Adjuvant hormonal therapy has been consistently proven to improve multiple outcomes in early breast cancer. Nonetheless, data on rates of adherence and persistence with therapy outside West Europe and North America are scarce. We assessed the adherence and persistence with adjuvant hormonal in a retrospective population based cohort of breast cancer survivors in Maccabi Health Services (MHS), Israel. Methods: We identified women who were diagnosed with breast cancer and initiated adjuvant hormonal therapy between January 2000 and November 2008. Subjects were followed retrospectively from first dispensed tamoxifen or aromatase inhibitor (AI) and up to the earliest of the following events: disease recurrence (indicated by surgery, radiotherapy, chemotherapy or other related therapies), leaving MHS, death, or completion of 5 years of treatment. Discontinuation of therapy was defined as a 180-day or longer treatment gap. Adherence with therapy was assessed using proportion of days covered (PDC) during follow-up period. Survival analysis was used to determine the effect of adherence on all-cause mortality. Results: A total of 4178 women with breast cancer were followed for a median 7.8 years. Over 90% of patients received tamoxifen as the initial hormonal agent. Mean PDC was 84% with lower rates associated with younger age, smoking status, comorbidities and year of diagnosis. Residential area did not affect adherence. Differences were not found. Discontinuation of therapy occurred in 23% of study patients. Among persistent patients, 70% were optimally adherent with therapy (PDC>=80%). Association between adherence with therapy and survival is investigated. Conclusions: Adherence to adjuvant hormonal therapy among Israeli breast cancer patients with national health insurance is high in comparison to international reports. Nevertheless, suboptimal adherence was identified among younger (<45y) patients. Because of the efficacy of hormonal therapy in preventing recurrence and death in women with early-stage breast cancer, interventions are necessary to identify and prevent suboptimal adherence among high risk subgroups.

scholarly journals Changing goals in the management of breast carcinoma patients towards preservation of feminity and quality of life

2018 ◽  
Vol 4 (2) ◽  
pp. 96-98
Author(s):  
Soumi Pathak ◽  
Ajay Kumar Bhargava
Keyword(s):  
Breast Cancer ◽  
Quality Of Life ◽  
Health Care ◽  
Developing Countries ◽  
Breast Carcinoma ◽  
Cancer Patients ◽  
Breast Cancer Survivors ◽  
Breast Cancer Patients ◽  
Health Care Burden

Breast cancer is the commonest cancer in women worldwide. In the developing countries of Asia, the health care burden on account of breast cancer has been steadily mounting. Over 100,000 new breast cancer patients are estimated to be diagnosed annually in India.1 As per the ICMR-PBCR data, breast cancer is the commonest cancer among women in urban registries of Delhi, Mumbai, Ahmedabad, Calcutta, and Trivandrum where it constitutes > 30% of all cancers in females. Previous literature on mastectomy indicates that the operation may be perceived by the patient as a threat to her feminity. Breast cancer survivors have dissatisfaction with appearance, perceived loss of femininity and body integrity, self-consciousness about appearance, and dissatisfaction with surgical scars… Journal of Society of Anesthesiologists of NepalVol. 4, No. 2, 2017, Page: 96-98 

scholarly journals The impact of lifestyle interventions on therapy associated side effects in postmenopausal breast cancer survivors: systematic reviews and meta-analysis

2019 ◽  
Author(s):  
Jean Paul Muambngu Milambo ◽  
Maritha Kotze ◽  
John Akudugu
Keyword(s):  
Breast Cancer ◽  
Adverse Events ◽  
Breast Cancer Survivors ◽  
Meta Analysis ◽  
Postmenopausal Breast Cancer ◽  
Controlled Trials ◽  
Lifestyle Interventions ◽  
Breast Cancer Patients ◽  
Related Quality

Abstract Background: Medically Supervised Exercise (MSE) are advisable for the prevention and treatment related side effects among breast cancer survivors. Aerobic and resistance either exercise, separately or in combination, have been shown to improve physical functioning and manage some symptoms in breast cancer patients. However, the level of evidence on the effects of lifestyle interventions on therapy related adverse events and the required dose responses of exercises are not yet systematically reviewed. This review was conducted to assess the efficacy of medically supervised exercises(MSE) coupled with diet in preventing/managing aromatase inhibitors induced adverse events and improving range of motion(ROM) and heath related quality of life (HRQOL) in postmenopausal breast cancer patients following treatment. Methods: Two independent authors extracted data using PRISMA guidelines of published clinical trials. We searched the Cochrane Central Register of Controlled Trials, PubMed, MEDLINE, EMBASE, as well as clinical practice guidelines. We included only randomized controlled trials that examined exercise interventions coupled with diet interventions in postmenopausal breast cancer women. Health related quality of life (HRQOL) and range of motion were assessed as the main outcomes. Results: Random effects meta-analysis was conducted for pooling of the effect size. The age of patients varied from 50 to 60 years. The results illustrate that the mean difference (MD) in improving ROM in the MSE group versus no supervised exercises was 1.35% (95% CI: 0.63 to 2.07%, P = 0.0002; heterogeneity: Tau² = 0.71; Chi² = 112.14, df = 5 (P < 0.00001); I² = 96%). A summary of the data shows that supervised exercises significantly improved ROM and HRQOL in postmenopausal BCS on endocrine therapy compared to no supervised exercises 3.02 (95% CI: 2.59 to 3.45, P < 0.00001). These outcomes show that lifestyle interventions (MSE +diet) have positive effects on AI-associated adverse events and likely improve ROM and HRQOL in postmenopausal BC patients. Conclusion: The evidence was based on a body of research with moderate study quality. Moreover, further studies are recommended to assess the effect of lifestyle interventions on markers of inflammation as the predictors of treatment non-response and associated comorbidities.

scholarly journals Neural Correlates and Functional Cognitive Maps in Breast Cancer Survivors Receiving Different Chemotherapy Regimens; a QEEG/HEG-based Investigation

2021 ◽  
Author(s):  
Maryam Vasaghi Gharamaleki ◽  
Seyedeh Zahra Mousavi ◽  
Maryam Owrangi ◽  
Mohammad Javad Gholamzadeh ◽  
Ali-Mohammad Kamali ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cancer Patients ◽  
Breast Cancer Survivors ◽  
Near Infrared ◽  
Chemotherapy Regimen ◽  
Current Source ◽  
Control Group ◽  
Breast Cancer Patients ◽  
Cognitive Domains ◽  
Clinical Disorder

Background: Post-chemotherapy cognitive impairment commonly known as "chemobrain" or "chemofog" is a well-established clinical disorder affecting various cognitive domains including attention, visuospatial working memory, executive function, etc. Although several studies have confirmed the chemobrain in recent years, scant experiments have evaluated the potential neurotoxicity of different chemotherapy regimens and agents. In this study, we aimed to evaluate the extent of attention deficits, one of the commonly affected cognitive domains, among breast cancer patients treated with different chemotherapy regimens through neuroimaging techniques. Methods: Breast cancer patients treated with two commonly prescribed chemotherapy regimens, AC-T and TAC, and healthy volunteers were recruited. Near-infrared hemoencephalography (nirHEG) and quantitative electroencephalography (qEEG) assessments were recorded for each participant at rest and during task performance to compare the functional cortical changes associated with each chemotherapy regimen. Results: The qEEG analysis revealed increased power of high alpha/low beta or sensorimotor rhythm (SMR) frequency in left fronto-centro-parietal regions involved in dorsal and ventral attention networks (DAN and VAN) in the AC-T-treated group comparing to the TAC and control group. The AC-T group also had the highest current source density (CSD) values in DAN and VAN-related centers in 10 and 15 Hz associated with the lowest Z-scored FFT coherence in the mentioned regions. Conclusions: The mentioned findings revealed increased cognitive workload and lack of cognitive ease in breast cancer patients treated with the AC-T regimen proposing the presumable neurotoxic sequelae of this chemotherapy regimen in comparison with the TAC regimen.

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