Self-reported arm and shoulder problems in breast cancer survivors in Sub-Saharan Africa: the African Breast Cancer-Disparities in Outcomes cohort study

Abstract Background Arm and shoulder problems (ASP), including lymphedema, were common among women with breast cancer in high-income countries before sentinel lymph node biopsy became the standard of care. Although ASP impair quality of life, as they affect daily life activities, their frequency and...

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Autores principales:	Pauline Boucheron, Angelica Anele, Annelle Zietsman, Moses Galukande, Groesbeck Parham, Leeya F. Pinder, Therese M.-L. Andersson, Benjamin O. Anderson, Milena Foerster, Joachim Schüz, Isabel dos Santos Silva, Valerie McCormack
Formato:	article
Lenguaje:	EN
Publicado:	BMC 2021
Materias:	Arm and shoulder problems Lymphedema Lymphoedema Lymphodema Sub-Saharan Africa Breast cancer Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282
Acceso en línea:	https://doaj.org/article/bd2fee967c1b419282fdefe9e5a1a861
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spelling	oai:doaj.org-article:bd2fee967c1b419282fdefe9e5a1a8612021-11-28T12:09:51ZSelf-reported arm and shoulder problems in breast cancer survivors in Sub-Saharan Africa: the African Breast Cancer-Disparities in Outcomes cohort study10.1186/s13058-021-01486-91465-542Xhttps://doaj.org/article/bd2fee967c1b419282fdefe9e5a1a8612021-11-01T00:00:00Zhttps://doi.org/10.1186/s13058-021-01486-9https://doaj.org/toc/1465-542XAbstract Background Arm and shoulder problems (ASP), including lymphedema, were common among women with breast cancer in high-income countries before sentinel lymph node biopsy became the standard of care. Although ASP impair quality of life, as they affect daily life activities, their frequency and determinants in Sub-Saharan Africa remain unclear. Methods All women newly diagnosed with breast cancer at the Namibian, Ugandan, Nigerian, and Zambian sites of the African Breast Cancer-Disparities in Outcomes (ABC-DO) cohort study were included. At each 3-month follow-up interview, women answered the EORTC-QLQ-Br23 questionnaire, including three ASP items: shoulder/arm pain, arm stiffness, and arm/hand swelling. We estimated the cumulative incidence of first self-reported ASP, overall and stratified by study and treatment status, with deaths treated as competing events. To identify determinants of ASP, we estimated cause-specific hazard ratios using Cox models stratified by study site. Results Among 1476 women, up to 4 years after diagnosis, 43% (95% CI 40–46), 36% (33–38) and 23% (20–25), respectively, self-reported having experienced arm/shoulder pain, stiffness and arm/hand swelling at least once. Although risks of self-reported ASP differed between sites, a more advanced breast cancer stage at diagnosis, having a lower socioeconomic position and receiving treatment increased the risk of reporting an ASP. Conclusion ASP are very common in breast cancer survivors in Sub-Saharan Africa. They are influenced by different factors than those observed in high-income countries. There is a need to raise awareness and improve management of ASP within the African setting.Pauline BoucheronAngelica AneleAnnelle ZietsmanMoses GalukandeGroesbeck ParhamLeeya F. PinderTherese M.-L. AnderssonBenjamin O. AndersonMilena FoersterJoachim SchüzIsabel dos Santos SilvaValerie McCormackBMCarticleArm and shoulder problemsLymphedemaLymphoedemaLymphodemaSub-Saharan AfricaBreast cancerNeoplasms. Tumors. Oncology. Including cancer and carcinogensRC254-282ENBreast Cancer Research, Vol 23, Iss 1, Pp 1-12 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Arm and shoulder problems Lymphedema Lymphoedema Lymphodema Sub-Saharan Africa Breast cancer Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282
spellingShingle	Arm and shoulder problems Lymphedema Lymphoedema Lymphodema Sub-Saharan Africa Breast cancer Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282 Pauline Boucheron Angelica Anele Annelle Zietsman Moses Galukande Groesbeck Parham Leeya F. Pinder Therese M.-L. Andersson Benjamin O. Anderson Milena Foerster Joachim Schüz Isabel dos Santos Silva Valerie McCormack Self-reported arm and shoulder problems in breast cancer survivors in Sub-Saharan Africa: the African Breast Cancer-Disparities in Outcomes cohort study
description	Abstract Background Arm and shoulder problems (ASP), including lymphedema, were common among women with breast cancer in high-income countries before sentinel lymph node biopsy became the standard of care. Although ASP impair quality of life, as they affect daily life activities, their frequency and determinants in Sub-Saharan Africa remain unclear. Methods All women newly diagnosed with breast cancer at the Namibian, Ugandan, Nigerian, and Zambian sites of the African Breast Cancer-Disparities in Outcomes (ABC-DO) cohort study were included. At each 3-month follow-up interview, women answered the EORTC-QLQ-Br23 questionnaire, including three ASP items: shoulder/arm pain, arm stiffness, and arm/hand swelling. We estimated the cumulative incidence of first self-reported ASP, overall and stratified by study and treatment status, with deaths treated as competing events. To identify determinants of ASP, we estimated cause-specific hazard ratios using Cox models stratified by study site. Results Among 1476 women, up to 4 years after diagnosis, 43% (95% CI 40–46), 36% (33–38) and 23% (20–25), respectively, self-reported having experienced arm/shoulder pain, stiffness and arm/hand swelling at least once. Although risks of self-reported ASP differed between sites, a more advanced breast cancer stage at diagnosis, having a lower socioeconomic position and receiving treatment increased the risk of reporting an ASP. Conclusion ASP are very common in breast cancer survivors in Sub-Saharan Africa. They are influenced by different factors than those observed in high-income countries. There is a need to raise awareness and improve management of ASP within the African setting.
format	article
author	Pauline Boucheron Angelica Anele Annelle Zietsman Moses Galukande Groesbeck Parham Leeya F. Pinder Therese M.-L. Andersson Benjamin O. Anderson Milena Foerster Joachim Schüz Isabel dos Santos Silva Valerie McCormack
author_facet	Pauline Boucheron Angelica Anele Annelle Zietsman Moses Galukande Groesbeck Parham Leeya F. Pinder Therese M.-L. Andersson Benjamin O. Anderson Milena Foerster Joachim Schüz Isabel dos Santos Silva Valerie McCormack
author_sort	Pauline Boucheron
title	Self-reported arm and shoulder problems in breast cancer survivors in Sub-Saharan Africa: the African Breast Cancer-Disparities in Outcomes cohort study
title_short	Self-reported arm and shoulder problems in breast cancer survivors in Sub-Saharan Africa: the African Breast Cancer-Disparities in Outcomes cohort study
title_full	Self-reported arm and shoulder problems in breast cancer survivors in Sub-Saharan Africa: the African Breast Cancer-Disparities in Outcomes cohort study
title_fullStr	Self-reported arm and shoulder problems in breast cancer survivors in Sub-Saharan Africa: the African Breast Cancer-Disparities in Outcomes cohort study
title_full_unstemmed	Self-reported arm and shoulder problems in breast cancer survivors in Sub-Saharan Africa: the African Breast Cancer-Disparities in Outcomes cohort study
title_sort	self-reported arm and shoulder problems in breast cancer survivors in sub-saharan africa: the african breast cancer-disparities in outcomes cohort study
publisher	BMC
publishDate	2021
url	https://doaj.org/article/bd2fee967c1b419282fdefe9e5a1a861
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Self-reported arm and shoulder problems in breast cancer survivors in Sub-Saharan Africa: the African Breast Cancer-Disparities in Outcomes cohort study

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