Characteristics of Postoperative Patients with Breast Cancer Aged 65 Years and Older

Objective: This study aimed to compare postoperative patients with breast cancer aged ≥65 years with those aged <65 years and clarify the characteristics of postoperative patients with breast cancer aged ≥65. Methods: In total, 376 patients in whom we were able to evaluate survey items one month after surgery were included in the study. Comorbidity, including diabetes mellitus and hypertension, shoulder range of motion (ROM), upper-limb function, and psychological problems, was evaluated. Results: Hypertension and diabetes mellitus were significantly higher in patients aged ≥65 years (the elderly group) than in those aged <65 years (the non-elderly group) (p < 0.05). Preoperative shoulder flexion ROM was significantly restricted in the elderly group compared with the non-elderly group (p < 0.05). Preoperative shoulder abduction ROM was significantly restricted in the elderly group compared with the non-elderly group (p < 0.05). At one month after surgery, upper-limb function was more impaired in the non-elderly group than in the elderly group (p < 0.05). In both groups, both ROM and upper-limb function were significantly impaired one month after surgery compared with before surgery (p < 0.05). Conclusions: Postoperative patients with breast cancer aged ≥65 years should be careful about risk management and intervention during rehabilitation. Preoperative evaluation of shoulder ROM should be performed because patients aged ≥65 years have limited ROM before surgery.

[1]  M. Tay,et al.  Prevalence and associations of axillary web syndrome in Asian women after breast cancer surgery undergoing a community-based cancer rehabilitation program , 2021, BMC cancer.

[2]  A. R. de Oliveira,et al.  Factors associated with upper limb dysfunction in breast cancer survivors , 2020, Supportive Care in Cancer.

[3]  N. Gebruers,et al.  Long-term morbidity after a negative sentinel node in breast cancer patients. , 2019, European journal of cancer care.

[4]  T. Hintsa,et al.  The relationship between anger regulation, mood, pain, and pain‐related disability in women treated for breast cancer , 2019, Psycho-oncology.

[5]  J. Małyszko,et al.  Hypertension prevalence in early breast cancer patients undergoing primary surgery. , 2019, Advances in medical sciences.

[6]  L. Mouton,et al.  Shoulder and elbow range of motion for the performance of activities of daily living: A systematic review , 2018, Physiotherapy theory and practice.

[7]  P. Neven,et al.  Pain characteristics as important contributing factors to upper limb dysfunctions in breast cancer survivors at long term. , 2017, Musculoskeletal science & practice.

[8]  M. Wallwiener,et al.  Adjuvant chemotherapy in elderly patients with primary breast cancer: are women ≥65 undertreated? , 2016, Journal of Cancer Research and Clinical Oncology.

[9]  Christine Miaskowski,et al.  Co-occurrence of anxiety and depressive symptoms following breast cancer surgery and its impact on quality of life. , 2016, European journal of oncology nursing : the official journal of European Oncology Nursing Society.

[10]  A. Stuckey,et al.  Breast Cancer Epidemiology and Risk Factors , 2011, Clinical obstetrics and gynecology.

[11]  Patrick Neven,et al.  Effectiveness of postoperative physical therapy for upper-limb impairments after breast cancer treatment: a systematic review. , 2015, Archives of physical medicine and rehabilitation.

[12]  Saranya Chumsri,et al.  Chemotherapy dose reduction due to chemotherapy induced peripheral neuropathy in breast cancer patients receiving chemotherapy in the neoadjuvant or adjuvant settings: a single-center experience , 2014, SpringerPlus.

[13]  J. König,et al.  Impact of different training modalities on glycaemic control and blood lipids in patients with type 2 diabetes: a systematic review and network meta-analysis , 2014, Diabetologia.

[14]  H. Cohen,et al.  Associations among survivorship care plans, experiences of survivorship care, and functioning in older breast cancer survivors: CALGB/Alliance 369901 , 2014, Journal of Cancer Survivorship.

[15]  X. Shu,et al.  Comorbidities and breast cancer survival: a report from the Shanghai Breast Cancer Survival Study , 2013, Breast Cancer Research and Treatment.

[16]  K. Campbell,et al.  The effect of prospective monitoring and early physiotherapy intervention on arm morbidity following surgery for breast cancer: a pilot study. , 2013, Physiotherapy Canada. Physiotherapie Canada.

[17]  D. Rose,et al.  Type 2 diabetes and obesity metabolic interactions: common factors for breast cancer risk and novel approaches to prevention and therapy. , 2012, Current diabetes reviews.

[18]  K. Refshauge,et al.  Upper limb progressive resistance training and stretching exercises following surgery for early breast cancer: a randomized controlled trial , 2012, Breast Cancer Research and Treatment.

[19]  M. Yunokawa,et al.  Paclitaxel-induced peripheral neuropathy in patients receiving adjuvant chemotherapy for breast cancer , 2013, International Journal of Clinical Oncology.

[20]  B. Fernhall,et al.  Exercise and Type 2 Diabetes , 2010, Diabetes Care.

[21]  L. Ngo,et al.  Breast cancer among the oldest old: tumor characteristics, treatment choices, and survival. , 2010, Journal of clinical oncology : official journal of the American Society of Clinical Oncology.

[22]  Sung-Won Kim,et al.  Longitudinal change of treatment‐related upper limb dysfunction and its impact on late dysfunction in breast cancer survivors: A prospective cohort study , 2010, Journal of surgical oncology.

[23]  B. Fernhall,et al.  Exercise and Type 2 Diabetes , 2010, Diabetes Care.

[24]  Benjamin D Smith,et al.  Future of cancer incidence in the United States: burdens upon an aging, changing nation. , 2009, Journal of clinical oncology : official journal of the American Society of Clinical Oncology.

[25]  G. Hortobagyi,et al.  Impact of diabetes mellitus on complications and outcomes of adjuvant chemotherapy in older patients with breast cancer. , 2009, Journal of clinical oncology : official journal of the American Society of Clinical Oncology.

[26]  A. Rodgers,et al.  Global burden of blood-pressure-related disease, 2001 , 2008, The Lancet.

[27]  K. Refshauge,et al.  Prognosis of the upper limb following surgery and radiation for breast cancer , 2008, Breast Cancer Research and Treatment.

[28]  T. Trappe,et al.  Collagen, cross-linking, and advanced glycation end products in aging human skeletal muscle. , 2007, Journal of applied physiology.

[29]  J. Hoyland,et al.  Morphology, mechanisms and pathology of musculoskeletal ageing , 2007, The Journal of pathology.

[30]  Xuguang Wang,et al.  Effects of age and gender on maximum voluntary range of motion of the upper body joints , 2006, Ergonomics.

[31]  C. Cooper,et al.  Type 2 diabetes, muscle strength, and impaired physical function: the tip of the iceberg? , 2005, Diabetes care.

[32]  L. Brinton,et al.  Global trends in breast cancer incidence and mortality 1973-1997. , 2005, International journal of epidemiology.

[33]  S. Yamawaki,et al.  Development of an Impact Thermometer for use in combination with the Distress Thermometer as a brief screening tool for adjustment disorders and/or major depression in cancer patients. , 2005, Journal of pain and symptom management.

[34]  J. Bullock-Saxton,et al.  Shoulder Movement After Breast Cancer Surgery: Results of a Randomised Controlled Study of Postoperative Physiotherapy , 2002, Breast Cancer Research and Treatment.

[35]  J. Bullock-Saxton,et al.  Physiotherapy After Breast Cancer Surgery: Results of a Randomised Controlled Study to Minimise Lymphoedema , 2002, Breast Cancer Research and Treatment.

[36]  R Yancik,et al.  Effect of age and comorbidity in postmenopausal breast cancer patients aged 55 years and older. , 2001, JAMA.

[37]  R. Elledge,et al.  Tumor characteristics and clinical outcome of elderly women with breast cancer. , 2000, Journal of the National Cancer Institute.

[38]  C. Bulpitt,et al.  Blood Pressure Lowering for the Primary and Secondary Prevention of Stroke: Treatment of Hypertension Reduces the Risk of Stroke , 1999, Journal of cardiovascular risk.

[39]  R. Holman,et al.  Risk factors for coronary artery disease in non-insulin dependent diabetes mellitus: United Kingdom prospective diabetes study (UKPDS: 23) , 1998, BMJ.

[40]  J. Guralnik,et al.  Assessing the impact of comorbidity in the older population. , 1996, Annals of epidemiology.

[41]  C. Bombardier,et al.  Development of an upper extremity outcome measure: The DASH (disabilities of the arm, shoulder, and head) , 1996 .

[42]  M. Laakso,et al.  Predictors of stroke in middle-aged patients with non-insulin-dependent diabetes. , 1996, Stroke.

[43]  R. Klein Hyperglycemie and Microvascular and Macrovascular Disease in Diabetes , 1995, Diabetes Care.

[44]  M. Laakso,et al.  NIDDM and Its Metabolic Control Predict Coronary Heart Disease in Elderly Subjects , 1994, Diabetes.

[45]  J. Neaton,et al.  Diabetes, Other Risk Factors, and 12-Yr Cardiovascular Mortality for Men Screened in the Multiple Risk Factor Intervention Trial , 1993, Diabetes Care.

[46]  E. Ford,et al.  Trends in Diabetes and Diabetic Complications, 1980–1987 , 1992, Diabetes Care.

[47]  H. Gutman,et al.  Achievements of physical therapy in patients after modified radical mastectomy compared with quadrantectomy, axillary dissection, and radiation for carcinoma of the breast. , 1990, Archives of surgery.