Poster 19: Upper-body function and other health outcomes in breast cancer survivors

Objective: To research the relationship among upper-body function and patient characteristics, type of breast cancer treatment, and emotional health among breast cancer survivors participating in a trial of nurse case management. Design: Prospective, randomized controlled trial. Setting: Patients were recruited from 60 surgeons in 13 community and 2 public hospitals in southeast Texas from November 1, 1993, to October 31, 1996. Participants: Women (N=335) with newly diagnosed breast cancer, who were at least 65 years old in community hospitals or at least 60 years old in public hospitals. Intervention: Receipt of nurse case management services. Main Outcome Measures: Upper-extremity range of motion (ROM) and emotional health (depression, anxiety, life satisfaction, mood) at 2 and 12 months after breast cancer diagnosis. Results: 55% of patients who received nurse case management demonstrated full ROM at 2 months in contrast to 40% for the control group (P=.025). Controlling for nurse case management status, women treated with mastectomy were less likely to have full ROM at 2 months compared with women treated with breast-conserving surgery plus radiation (44% vs 74%, P<.003). At 12 months, African-American women were less likely to have full ROM than white women (66% vs 81%, P=.40). Full ROM was significantly associated (P<.05) with all measures of positive emotional health at both time periods. Conclusion: Women with nurse case management had significantly better upper-body function at 2 months after diagnosis compared with women without case management. The type of breast surgery and race were risk factors for decreased arm mobility at 2 months and 12 months. Full ROM was associated with better emotional health at both time periods.