Long-Term Breast Cancer Treatment Effects: Limb Volume Changes

长期乳腺癌治疗效果：肢体体积变化

• 批准号: 7626657
• 负责人: Jane M Armer
• 金额: $ 53.99万
• 依托单位: UNIVERSITY OF MISSOURI-COLUMBIA
• 依托单位国家: 美国
• 财政年份: 2006
• 资助国家: 美国
• 起止时间: 2006-09-20 至 2011-12-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7626657
• 关键词: Aftercare; Award; Breast Cancer Treatment; Cancer Patient; Cancer Survivor; Characteristics; Chronic Disease; Complex; Data; Diagnosis; Effectiveness; Family; Frequencies; Funding; Goals; Health; Health Status; Incidence; Intervention; Investigation; Limb structure; Long-Term Effects; Longitudinal Studies; Lymphedema; Measurement; Measures; Mediating; Mediator of activation protein; Minority; Outcome; Patient Self-Report; Perception; Persons; Prevalence; Problem Solving; Quality of life; Recovery; Research Personnel; Risk; Risk Reduction; Rural; Sampling; Severities; Signs and Symptoms; Social support; Survivors; Swelling; Symptoms; Time; United States National Institutes of Health; base; breast cancer diagnosis; coping; design; experience; follow-up; functional outcomes; improved; malignant breast neoplasm; physical conditioning; programs; prospective; psychologic; psychosocial; psychosocial adjustment; survivorship; symptom management; time use; treatment duration; treatment effect

DESCRIPTION (provided by applicant): Limited information exists regarding the common physical, functional, and psychological effects that arise late in the course of breast cancer treatment and recovery. The proposed study will first describe the incidence, prevalence, and related symptoms of early- and late-onset Iymphedema (LE) among persons diagnosed with breast cancer and followed from pre- and post-op baseline through 3 to 7years after treatment in a predominantly rural Midwestern state. We propose to then examine the long-term effects of post-treatment lymphedema at 3 to 7 years after diagnosis on psychosocial adjustment and functional health status. The sample for this prospective longitudinal study includes breast cancer survivors, already accrued at pre-op (N=290 of 300, soon to be completing an earlier RO1 study), who will be followed an additional 3 to 7 years post-diagnosis. The study has one primary (Aim 1) and three secondary aims (Aims 2.1, 2.2, and 2.3). These include: First, (Aim 1) To explore in breast cancer survivors over time (from baseline through 3 to 7 yrs after diagnosis): (a) limb volume and limb volume changes (LVC), (b) associated LE-related symptoms, (c) problem solving and social support; (d) levels of perceived coping effectiveness and ways of managing LE symptoms; and (e) the outcome variables of psychosocial adjustment and functional health status. Further, as secondary aims, we propose to explore: (Aim 2.1) associations among (a) perceived coping effectiveness and ways of managing LE symptoms with (b) LVC and associated LE-related symptoms; (Aim 2.2) associations of the above-mentioned post-treatment changes (LVC, symptoms, perceived coping effectiveness, and ways of managing symptoms) on psychosocial adjustment and functional health status; and (Aim 2.3) the complex interactions of these predisposing, mediating, and moderating variables on psychosocial adjustment and functional health status over time. Internal funding, contingent upon the NIH award, will support the recruitment and retention of an additional 100 breast cancer survivors to be followed 3 to 7 years post-diagnosis, enabling us to increase minority recruitment and to carry out more sophisticated subgroup analysis. Results of this longitudinal investigation will provide ground-breaking new information about the onset and progression of lymphedema and their impact on psychosocial adjustment and functional health status over an extended time. These findings will form the basis for design and timing of subsequent interventions with breast cancer survivors aimed at reducing LE risk and improving symptom management and overall survivorship quality of life. Without further funding, after April 30, 2006, this opportunity for long-term follow-up will be lost.

描述（由申请人提供）：关于乳腺癌治疗和康复过程后期出现的常见身体、功能和心理影响的信息有限。这项研究首先描述了在美国中西部一个主要的农村州，乳腺癌患者中早发性和迟发性淋巴水肿（LE）的发病率、患病率和相关症状，并从术前和术后基线到治疗后3 - 7年进行随访。我们建议在诊断后3至7年检查治疗后水肿对心理社会适应和功能健康状况的长期影响。这项前瞻性纵向研究的样本包括乳腺癌幸存者，在术前已经累积（N = 290/300，即将完成早期的RO1研究），将在诊断后额外随访3 - 7年。本研究有一个主要目标（目标1）和三个次要目标（目标2.1、2.2和2.3）。其中包括：首先，（目的1）探索乳腺癌幸存者随时间的变化（从基线到诊断后3 - 7年）：（a）肢体体积和肢体体积变化（LVC），（B）相关LE相关症状，（c）解决问题和社会支持;（d）感知应对有效性水平和管理LE症状的方法;以及（e）心理社会调整和功能健康状态的结果变量。此外，作为次要目标，我们建议探讨：（目标2.1）（a）感知的应对有效性和管理LE症状的方式与（B）LVC和相关LE相关症状之间的关联;（目标2.2）上述治疗后变化的相关性（LVC，症状，感知应对有效性和管理症状的方式）对心理社会适应和功能健康状况的影响;以及（目标2.3）随着时间的推移，这些诱发、中介和调节变量对心理社会适应和功能健康状况的复杂相互作用。内部资金，取决于美国国立卫生研究院的奖励，将支持招募和保留额外的100名乳腺癌幸存者，在诊断后3至7年进行随访，使我们能够增加少数族裔的招募，并进行更复杂的亚组分析。这项纵向调查的结果将提供有关水肿的发病和进展及其在较长时间内对心理社会调整和功能健康状况的影响的突破性新信息。这些研究结果将成为乳腺癌幸存者后续干预措施的设计和时机的基础，旨在降低LE风险，改善症状管理和整体生存生活质量。如果没有进一步的资金，2006年4月30日之后，将失去长期随访的机会。