Long-term Arm Morbidity Following Breast Cancer Treatment

描述（由申请人提供）：大约87%接受乳腺癌治疗的女性预计存活5年或更长时间。然而，关于这些女性手臂发病率及其对功能状态、情绪和生活质量（QOL）影响的长期、前瞻性随访研究非常有限。事实上，这项拨款申请中提出的研究将是第一个关于乳腺癌治疗后手臂发病率和患者预后的前瞻性纵向研究，该研究具有乳腺癌手术前手臂发病率结局的基线数据。本研究的女性将从一项正在进行的NCI资助的研究中招募，该研究正在评估乳腺癌手术后神经性疼痛的患病率、严重程度和发生时间，以及预测这些症状发展的因素。本研究的女性（n=590）在手术前招募，随访12个月。在本研究中，我们建议根据入组时间，继续对这些女性进行3 - 4年的随访。拟议研究的具体目的是：确定淋巴水肿（LE）的患病率、严重程度和发病时间；确定与LE相关的肩部活动能力和握力变化的发生率和发生时间；比较发生和未发生LE的女性在焦虑、抑郁情绪、疲劳、睡眠障碍、功能状态和生活质量（QOL）方面的差异；并确定预测LE发展的因素。本研究的第二个目的是开始阐明乳腺癌手术后神经性疼痛和LE的遗传标记。这项前瞻性纵向研究的结果将用于确定手臂发病率高风险的妇女，并指导手臂发病率干预措施的发展。摘要：本研究将确定乳腺癌手术后发生LE的女性比例以及LE对手臂功能的影响。此外，还将评估女性患LE的风险。

DESCRIPTION (provided by applicant): Approximately 87% of women who undergo treatment for breast cancer are expected to survive for 5 years or longer. However, long-term, prospective follow-up studies of arm morbidity and its impact on functional status, mood, and quality of life (QOL) in these women are extremely limited. In fact, the study proposed in this grant application will be the first prospective longitudinal study of arm morbidity and patient outcomes following breast cancer treatment that has baseline data on arm morbidity outcomes prior to breast cancer surgery. Women for this study will be recruited from an ongoing NCI funded study that is evaluating the prevalence, severity, and timing of occurrence of neuropathic pain following breast cancer surgery and the factors that predict the development of these symptoms. Women (n=590) in the current study are recruited prior to surgery and are followed for 12 months. In this study, we propose to continue to follow these women for and additional 3 to 4 years depending on the time of enrollment. The specific aims of the proposed study are to: determine the prevalence, severity, and the timing of the lymphedema (LE); determine the prevalence and timing of occurrence of changes in shoulder mobility and changes in grip strength associated with LE; compare differences in anxiety, depressed mood, fatigue, sleep disturbance, functional status, and quality of life (QOL) in women who do and do not develop LE; and determine the factors that predict the development of LE. A secondary aim of this study is to begin to elucidate genetic markers for neuropathic pain and LE following breast cancer surgery. Findings from this prospective, longitudinal study will be used to identify women who are at high risk for arm morbidity and to guide the development of interventions for arm morbidity. Lay Summary: This study will determine what percentage of women develop LE after breast cancer surgery and the effects of LE on arm function. In addition, what places a woman at risk for LE will be evaluated.