BibTex format
@article{Johnson:2024:10.1016/j.ejso.2024.108591,
author = {Johnson, M-C and McGregor, AH and A'Hern, R and Leff, DR and Wells, M},
doi = {10.1016/j.ejso.2024.108591},
journal = {European Journal of Surgical Oncology},
title = {'I presumed the pain would eventually get better by itself'; challenges with access to rehabilitation for upper limb dysfunction after breast cancer treatment - descriptive and qualitative findings from a cross-sectional survey},
url = {http://dx.doi.org/10.1016/j.ejso.2024.108591},
volume = {50},
year = {2024}
}
RIS format (EndNote, RefMan)
TY - JOUR
AB - PURPOSE: Sixty percent of breast cancer patients develop persistent upper limb pain and dysfunction, but only limited knowledge exists about how these symptoms relate to rehabilitation access. METHODS: A postal survey was sent to patients treated at a London University Teaching Hospital (2018-2020). Data were collected on pain (Pain Detect), shoulder function (Disability of Shoulder Arm and Hand (DASH)), quality-of-life (QoL) (EQ-5D-5L), and clinical characteristics, including treatment and access to rehabilitation. The free-text section invited patients' comments on upper limb symptoms and management strategies, which were analysed thematically. Quantitative data were analysed descriptively, and the medians were examined with Mann-Whitley U-Tests or Kruskal-Wallis Test. RESULTS: Of 511 patients surveyed, 162 (32 %) questionnaires were returned and analysed. Respondents' mean age was 62 years (SD 11.3). The majority had Sentinel Node Biopsy 71 % (116/162) and mastectomy 61 % (99/162). 73 % (119/162) reported pain. Mean (SD) Pain Detect and DASH Score were respectively 11.07 (7) and 21.7 (21.5), with 51 % recording significant shoulder dysfunction, and only 28 % reporting access to rehabilitation. Individuals with neuropathic pain had significantly higher median (range) DASH score 60.8 (35.8, 75.0) p = 0.000. Median DASH score for sedentary individuals was significantly higher 22.9 (7.9, 31.8) p = 0.0009. Free-text analysis revealed persistent, progressive symptoms, mixed attitudes towards exercise and variations in access to rehabilitation and support. CONCLUSION: Two years following surgery many patients reported significant upper limb symptoms which adversely impact on QoL. However, approximately two thirds did not access potentially beneficial rehabilitation treatments. There is a need to improve pathways of care.
AU - Johnson,M-C
AU - McGregor,AH
AU - A'Hern,R
AU - Leff,DR
AU - Wells,M
DO - 10.1016/j.ejso.2024.108591
PY - 2024///
SN - 0748-7983
TI - 'I presumed the pain would eventually get better by itself'; challenges with access to rehabilitation for upper limb dysfunction after breast cancer treatment - descriptive and qualitative findings from a cross-sectional survey
T2 - European Journal of Surgical Oncology
UR - http://dx.doi.org/10.1016/j.ejso.2024.108591
UR - https://www.ncbi.nlm.nih.gov/pubmed/39146662
UR - https://www.sciencedirect.com/science/article/pii/S0748798324006437?via%3Dihub
VL - 50
ER -